Wash. Rev. Code § 43.70.066

Study--Uniform quality assurance and improvement program--Reports to legislature--Limitation on rule making

The Department of Health (“department”) must study whether participation in a “uniform quality assurance and improvement program” by all health plan, health providers, and facilities operating in Washington is possible.

The department must consult with health care purchasers, carriers, providers, facilities, and consumers while conducting the study. The department must propose standards that will meet the needs of all stakeholders but also provide all consumers with “the same level of quality assurance.”

At minimum, the department must design the study to include the following elements:

•         Standards for the training, credentialing, and licensure of health care providers.
•         Standards for the credentialing and recredentialing of health care facilities.
•         A health care facility staff ratio
•         Adjusted annual mortality and morbidity rates for specified procedures or diagnoses.
•         The average costs and length of hospitalization for specified procedures and diagnoses.
•         The total number of procedures, by specialty, performed by each physician at a health care facility within the previous year.
•         Adjusted utilization performance profiles.
•         Health plan financial performance standards.
•         Provider and facility recordkeeping and reporting standards.
•         Health care utilization management that monitors trends in health service.
•         Health monitoring that is responsive to consumer, purchaser, and public health needs.

The department must establish standards that allow participating facilities, providers, and carriers to determine the physical method of collection, storage, and assimilation of quality indicators to be disclosed to consumers.  However, the department will determine the form and frequency of disclosing information.

Related Laws:  Wash. Rev. Code § 43.70.064