wa-law.org > bill > 2023-24 > HB 1725 > Original Bill
As soon as is reasonably practicable, the health care authority shall establish the insulin for individuals under the age of 21 bulk purchasing and distribution program. The health care authority is authorized to:
Purchase or enter into contracts as necessary to purchase and distribute insulin, collect an assessment, and administer the program;
Bill, charge, and receive payment from health carriers, managed health care systems, and to the extent that any self-insured health plans choose to participate, self-insured health plans; and
Perform any other functions as may be necessary or proper to establish and administer the program.
To establish and administer the insulin for individuals under the age of 21 bulk purchasing and distribution program, the health care authority may adopt rules providing the following:
A dosage-based assessment and formula to determine the assessment for insulin provided to an individual through the program that includes administrative costs of the program;
The mechanism, requirements, and timeline for health carriers, managed health care systems, and self-insured plans to pay the dosage-based assessments;
The types of health care facilities, health care providers, or other entities that are required to or are permitted to participate in the program;
The billing procedures for any participating health care facility, health care provider, or other entity participating in the program; and
Any other rules necessary to establish, implement, or administer the program.
The following agencies, health plans, and insurers shall participate in the insulin for individuals under the age of 21 bulk purchasing and distribution program:
Health carriers;
Managed health care systems administering a medicaid managed care plan; and
The health care authority for purposes of:
Health plans offered to public employees and their dependents;
Individuals enrolled in medical assistance under chapter 74.09 RCW that are not enrolled in a managed care plan; and
Uninsured individuals.
The health care authority may establish an interest charge for late payment of any assessment under this section. The health care authority shall assess a civil penalty against any health carrier, managed health care system, or self-insured health plan that fails to pay an assessment within three months of billing. The civil penalty under this subsection is 150 percent of such assessment. The health care authority is authorized to file liens and seek judgment to recover amounts in arrears and civil penalties, and recover reasonable collection costs, including reasonable attorneys' fees and costs. Civil penalties so levied must be deposited in the insulin account created in section 2 of this act.
The health care authority in coordination with the office of the insurance commissioner may recommend to the appropriate committees of the legislature the termination of the insulin for individuals under the age of 21 bulk purchasing and distribution program if it finds that the original intent of its formation and operation has not been achieved.
By January 1, 2024, the health care authority shall submit a report to the legislature on the progress towards establishing the insulin for individuals under the age of 21 bulk purchasing and distribution program. The health care authority shall submit an updated report on the progress towards establishing the insulin for individuals under the age of 21 bulk purchasing and distribution program by January 1, 2025.
By July 1, 2026, the health care authority shall submit recommendations to the appropriate committees of the legislature on whether and how the insulin for individuals under the age of 21 bulk purchasing and distribution program may be expanded to include other prescription drugs.
The insulin account is created in the custody of the state treasurer. All receipts from collections under section 1 of this act must be deposited into the account. Expenditures from the account may be used only for the operation and administration of the insulin for individuals under the age of 21 bulk purchasing and distribution program identified in section 1 of this act. Only the director of the health care authority or the director's designee may authorize expenditures from the account. The account is subject to allotment procedures under chapter 43.88 RCW, but an appropriation is not required for expenditures.
All contracts must be entered into pursuant to competitive solicitation, except for:
A health plan offered to public employees and their covered dependents under this chapter that is issued or renewed on or after January 1, 2024, shall participate in the insulin for individuals under the age of 21 bulk purchasing and distribution program established in section 1 of this act once the program is operational.
For health plans issued or renewed on or after January 1, 2024, health carriers shall participate in the insulin for individuals under the age of 21 bulk purchasing and distribution program established in section 1 of this act once the program is operational.
Upon initiation or renewal of a contract with the authority to administer a medicaid managed care plan, a managed health care system shall participate in the insulin for individuals under the age of 21 bulk purchasing and distribution program established in section 1 of this act once the program is operational.
The authority shall participate in the insulin for individuals under the age of 21 bulk purchasing and distribution program established in section 1 of this act once the program is operational for purposes of individuals enrolled in medical assistance under this chapter that are not enrolled in a managed care plan and are uninsured individuals.
The health care authority may adopt rules necessary to implement this act.
The insurance commissioner may adopt rules necessary to implement sections 1 and 5 of this act.