WA: OIC Adopts Network Adequacy Rule Despite Criticism from Stakeholders

The Office of the Insurance Commissioner (OIC) was urged by health care stakeholders of various stripes to not adopt its proposed rule on network adequacy.  But in the end, the OIC went ahead anyway.

The final rule was quietly published last Friday afternoon, but the news release was not sent out until Monday morning.  So hospital and health plan representatives had one last weekend to continue hoping the rule might not be adopted after all.

The proposed rule, issued in March, had drawn heavy criticism, both in letters submitted to the OIC by April 21, and in verbal testimony at a hearing held in Tumwater on April 22.

The criticism has been circulating around the health care community for several weeks.  But the volume reached a crescendo last week, causing the OIC to delay its publication of the final rule by a few days but no longer.

One aspect of the criticism has been the insurance industry’s contention that the rules are unworkable, as DJ Wilson told the Spokesman Review last week. He said the rule could also put a real strain on the rural health care delivery system.

Comments submitted to the OIC are summarized in a “concise explanatory statement” of 84 pages that the agency released along with publication of the rule. The agency also includes its responses to each of the summarized comments, which cover a wide range of concerns, including the timeline of the rule and the ability of insurers to comply with so many new reporting requirements.