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Oregon — The Oregon Division of Financial Regulation Adoption of insulin cost-sharing rule:
ID 4-2022: Adoption of insulin cost-sharing rule
Adopt Rule: 836-053-0025
Rule summary: Regulation of the insulin co-pay amount for health benefit plans.
Filed: June 16, 2022
Effective: July 1, 2022
For more information on this recently adopted rule, please visit the division’s website:
https://dfr.oregon.gov/laws-rules/Documents/id04-2022_rule-order.pdf Oregon — The Oregon Division of Financial Regulation Amendment to 2023 standard bronze and silver health benefit plan
ID 3-2022: Amendment to 2023 standard bronze and silver health benefit plan
Rule affected: 836-053-0013
Rule summary: Update standard bronze and silver plans.
Filed: June 16, 2022
Effective: July 1, 2022
For more information on this recently adopted rule, please visit the division’s website:
https://dfr.oregon.gov/laws-rules/Documents/id03-2022_rule-order.pdf
Oregon — The Oregon Division of Financial Regulation OAR 836-042-0045
Filing Caption: In the matter of amending OAR 836-042-0045 relating to workers’ compensation statistical plans
Amend Rule: 836-042-0045
Rule Summary: Amended for revisions to become effective on or before October 1, 2022, is prescribed as the statistical plan for workers’ compensation and employers’ liability insurance.
Filed: June 29, 2022
Hearing: July 25, 2022, 2:00 PM
This is a hybrid meeting conducted in-person and virtually via Microsoft TEAMS. See Notice for TEAMS meeting instructions.
Last day/time to offer comment: July 29, 2022, 5:00 PM
For more information on this recently adopted rule, please visit the division’s website:
https://dfr.oregon.gov/laws-rules/Documents/Proposed/20220725-wc-statistical-plans.pdf
Oregon — The Oregon Division of Financial Regulation Issuance of Group Health Benefit Coverage to Employer Association
Filing Caption: Issuance of Group Health Benefit Coverage to Employer Association
Adopt Rule: 836-053-0006 Rule Summary: Defines the term “employer association” and specifies the items that a health insurance carrier must provide to the department for approval prior to issuing group health benefit coverage to an employer association. Requires carriers to notify the department of any changes to the required information at least annually.
Filed: June 22, 2022
Hearing: July 25, 2022, 1:15 PM
This is a hybrid meeting conducted in-person and virtually via Microsoft TEAMS. See Notice for TEAMS meeting instructions.
Last day/time to offer comment: July 29, 2022, 5:00 PM
For more information on this recently adopted rule, please visit the division’s website:
https://dfr.oregon.gov/laws-rules/Documents/Proposed/20220725-group-health-benefit-coverage.pdf
Washington — Kreidler extends emergency order on coverage for COVID-19 counseling: Insurance Commissioner Mike Kreidler extends his emergency order on coverage for counseling on the COVID-19 vaccine to August 5, 2022.
Washington — Notice of rulemaking on Small pharmacies reporting requirements: reimbursement appeals (R 2022-07): We are starting rulemaking R 2022-07 to update existing rules for small pharmacies filing appeals under subchapter E of WAC chapter 284-180 to current procedures for process/review: emphasizing electronic processing (versus mailing) and remove the requirement for sensitive information to be filed with an appeal.
The process for small pharmacy reimbursement settlements with pharmacy benefit manager process has changed such that initial intake of appeals to OIC are no longer handled by the Hearings Unit. The tier II review of appeals are conducted by an Administrative Law Judge at the Office of Administrative Hearings
Comments are due August 15, 2022; please send them to rulescoordinator@oic.wa.gov.
For more information, including the notice to start rulemaking (CR-101), please visit the rule’s webpage.
Washington — Cost-sharing for prescription drugs prepublication draft posted: We released a prepublication draft for the cost-sharing for prescription drugs rule (R 202-05). This proposed rule implements SSB 5610 chapter 228, Laws of 2022 which permits third party cost sharing for prescription drugs within specific parameters and establishes consistency in applying payments. Amendments to rules are made for consistency in definitions with a third party payment; clarity in pharmacy exceptions and appeals process; and, the application of cost sharing paid by a third party for the purposes of high deductible plans in accordance with federal guidance.
We scheduled an interested parties meeting through Zoom on July 12, 2022 at 9:00 a.m.. If you are interested in joining the meeting, please register for the meeting via Zoom.
Comments on the prepublication draft are due July 15, 2022; please send them to rulescoordinator@oic.wa.gov.
For more information, including the text of the prepublication draft, please visit the rule’s webpage.
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