WA: In Last-Ditch Effort, Hospitals & Health Plans Urge OIC to Delay Rulemaking


Representatives of Washington hospitals and health insurance companies, among others, urged the state Office of the Insurance Commissioner (OIC) to delay adoption of its proposed network-adequacy rule during testimony at a public hearing held Tuesday morning at the OIC’s offices in Tumwater.

The hearing was held one day before the OIC is expected to adopt its proposed rule relating to provider networks, which will apply to carriers submitting filings to offer plans for 2015.

Representatives of health insurance companies urged the OIC to postpone adoption of the rule.

Sydney Smith Zvara of the Association of Washington Healthcare Plans noted that the rulemaking process has been a “rushed and confusing process” for all concerned. “We urge you to delay this rulemaking until federal guidelines come out and we have enough time to get clarity,” she said.

Chris Bandoli, representing Regence BlueShield, said the carrier has significant concerns about “the really short timeframe” to implement the new rules prior to the May 1 deadline for carriers to submit exchange-plan filings for 2015.  “We’d just like to put forth in public that we hope there will be a willingness to be flexible on both sides in feeling our way through how this works as we move through the filing process,” Bandoli said.

Katie Rogers of Coordinated Care also pointed to the burden on carriers that would result from adopting a new rule on provider networks only one week before the filing deadline.  She warned that the proposed rule is so burdensome that it could discourage some carriers from submitting plans for the exchange, which runs counter to the goal of increasing consumer choice under the Affordable Care Act.

The hospitals were also insistent about the need, in their view, to delay adoption of the rule.

A representative of the Washington State Hospital Association urged the delay, citing the “unreasonably tight timeline that was really not adequate to this enormous task.”

Dr. Mark Del Beccaro, a pediatrician and vice president of medical affairs  at Seattle Children’s Hospital, said the hospital is requesting that the OIC pull back the draft rule and continue its development before finalizing it.

“Our recommendation to pull back is not taken lightly, in view of how much work has gone into it,” Beccaro said.  “But we feel this is critically important because of the effects it will have on health care consumers and especially children in this state, and we believe more time is necessary.”

However, it appears there is little chance the health plans and hospitals will influence Commissioner Mike Kreidler’s decision to adopt the new rules.

In an op-ed published in the Puget Sound Business Journal last Friday, Kreidler wrote:

Doing nothing or delaying is not an option. I recognize that we may not get everything right the first time, but my guidepost will be the same as it has always been: protecting consumers. I believe that is a point most of us can agree on.