(1) The authority shall
coordinate state agency efforts to develop and implement uniform
policies across state purchased health care programs that will
ensure prudent, cost-effective health services purchasing,
maximize efficiencies in administration of state purchased health
care programs, improve the quality of care provided through state
purchased health care programs, and reduce administrative burdens
on health care providers participating in state purchased health
care programs. The policies adopted should be based, to the
extent possible, upon the best available scientific and medical
evidence and shall endeavor to address:
(a) Methods of formal assessment, such as a health
technology assessment under RCW 70.14.080 through 70.14.130.
Consideration of the best available scientific evidence does not
preclude consideration of experimental or investigational
treatment or services under a clinical investigation approved by
an institutional review board;
(b) Monitoring of health outcomes, adverse events, quality,
and cost-effectiveness of health services;
(c) Development of a common definition of medical necessity;
and
(d) Exploration of common strategies for disease management
and demand management programs, including asthma, diabetes, heart
disease, and similar common chronic diseases. Strategies to be
explored include individual asthma management plans. On January
1, 2007, and January 1, 2009, the authority shall issue a status
report to the legislature summarizing any results it attains in
exploring and coordinating strategies for asthma, diabetes, heart
disease, and other chronic diseases.
(2) The administrator may invite health care provider
organizations, carriers, other health care purchasers, and
consumers to participate in efforts undertaken under this
section.
(3) For the purposes of this section "best available
scientific and medical evidence" means the best available
clinical evidence derived from systematic research.
[2006 c 307 § 8; 2005 c 462 § 3; 2003 c 276 § 1.]
NOTES:
Captions not law -- Conflict with federal requirements -- 2006 c 307: See notes following RCW 70.14.080.
Findings -- 2005 c 462: See note following RCW 28A.210.370.
Rule making -- 2003 c 276: "Agencies administering state purchased health care programs shall cooperatively adopt rules necessary to implement this act." [2003 c 276 § 2.]