(1) The secretary shall estimate the total nonfederal
program cost for the upcoming calendar year by October 1, 2010,
and October 1st of each year thereafter. Additionally, the
secretary shall subtract any amounts needed to serve children
enrolled in state purchased health care programs covering
low-income children for whom federal vaccine funding is not
available, and report the final amount to the association. In
addition, the secretary shall perform such calculation for the
period of May 1st through December 31st, 2010, as soon as
feasible but in no event later than April 1, 2010. The estimates
shall be timely communicated to the association.
(2) The board of directors of the association shall
determine the method and timing of assessment collection in
consultation with the department of health. The board shall use
a formula designed by the board to ensure the total anticipated
nonfederal program cost, minus costs for other children served
through state-purchased health care programs covering low-income
children, calculated under subsection (1) of this section, is
collected and transmitted to the universal vaccine purchase
account created in RCW 43.70.720 in order to ensure adequacy of
state funds to order state-supplied vaccine from federal centers
for disease control and prevention.
(3) Each licensed health carrier and each third-party
administrator on behalf of its clients' health benefit plans must
be assessed and is required to timely remit payment for its share
of the total amount needed to fund nonfederal program costs
calculated by the department of health. Such an assessment
includes additional funds as determined necessary by the board to
cover the reasonable costs for the association's administration.
The board shall determine the assessment methodology, with the
intent of ensuring that the nonfederal costs are based on actual
usage of vaccine for a health carrier or third-party
administrator's covered lives. State and local governments and
school districts must pay their portion of vaccine expense for
covered lives under this chapter.
(4) The board of the association shall develop a mechanism
through which the number and cost of doses of vaccine purchased
under this chapter that have been administered to children
covered by each health carrier, and each third-party
administrator's clients health benefit plans, are attributed to
each such health carrier and third-party administrator. Except
as otherwise permitted by the board, this mechanism must include
at least the following: Date of service; patient name; vaccine
received; and health benefit plan eligibility. The data must be
collected and maintained in a manner consistent with applicable
state and federal health information privacy laws. Beginning
November 1, 2011, and each November 1st thereafter, the board
shall factor the results of this mechanism for the previous year
into the determination of the appropriate assessment amount for
each health carrier and third-party administrator for the
upcoming year.
(5) For any year in which the total calculated cost to be
received from association members through assessments is less
than the total nonfederal program cost, the association must pay
the difference to the state for deposit into the universal
vaccine purchase account established in RCW 43.70.720. The board
may assess, and the health carrier and third-party administrators
are obligated to pay, their proportionate share of such costs and
appropriate reserves as determined by the board.
(6) The aggregate amount to be raised by the association in
any year may be reduced by any surpluses remaining from prior
years.
(7) In order to generate sufficient start-up funding, the
association may accept prepayment from member health carriers and
third-party administrators, subject to offset of future amounts
otherwise owing or other repayment method as determined by the
board. The initial deposit of start-up funding must be deposited
into the universal vaccine purchase account on or before April
30, 2010.
[2010 c 174 § 4.]