WAC 246-305-001   Purpose and scope.  (1) Purpose. These rules are adopted by the Washington state department of health to implement the provisions of RCW 43.70.235 regarding the certification of independent review organizations (IROs). Certified IROs are qualified to receive referrals from the insurance commissioner or designee under RCW 48.43.535 to make binding determinations related to health care coverage and payment disputes between health insurance carriers and their enrollees.

     (2) Other applicable rules. Independent review is also subject to rules of the insurance commissioner implementing RCW 48.43.535.

     (3) Applicability. These rules apply to independent review cases originating in Washington state under RCW 48.43.535, and to independent review organizations conducting these reviews.



[Statutory Authority: RCW 43.70.235 and 48.43.535. 11-23-124, § 246-305-001, filed 11/21/11, effective 11/26/11; 01-08-023, § 246-305-001, filed 3/28/01, effective 4/28/01.]