Around the PIA Western Alliance States

California — Applied Underwriters Loses Appeal: Applied Underwriters and the California Insurance Company filed a federal lawsuit against the California Department of Insurance (CDI) over the merger of the two companies.

The U.S. Court of Appeals for the Ninth Circuit ruled in favor of the CDI and said the attempted merger and subsequent move to New Mexico was designed to get around conservatorship.

The case got really complicated when New Mexico’s attorney general got involved and when allegations of impropriety by California Insurance Commissioner Ricardo Lara who got campaign contributions totaling $54,300 from people linked to Applied Underwriters and Independence Holding Co.

Source link: Insurance Journal — https://www.insurancejournal.com/news/west/2022/06/10/671408.htm

Washington — Notice of rulemaking on Accessing and receiving health care services and benefits (R 2022-03): We are starting rulemaking (R 2022-03) to amend the existing rules as needed to be consistent with new laws regarding accessing and receiving health care services and benefits, including, but not limited to, those related to immediate post-partum contraception, donor human milk and audio-only telehealth.

At this time, we are soliciting comments in order to help determine whether rulemaking may be needed in relation to two of those laws.

Comments are due July 8, 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 — Notice of rulemaking on Statement requirement for consumer adverse benefit determination notices (R 2022-04): We are starting rulemaking (R 2022-04) to amend the existing rules so that a required statement for consumer adverse benefit determination notices will be at a lower, more appropriate reading level.

Comments are due July 8, 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 — Notice of rulemaking on Cost sharing for prescription drugs (R 2022-05): We are starting rulemaking (R 2022-05) to implement 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 will be addressed in accordance with federal guidance. Rules will amend chapter 284-43 for Prescription drug benefit design changes made in accordance with the new law.The rules will facilitate implementation of the law and afford the consumer protection intended under the new law.

Comments are due July 15, 2022; please send them to rulescoordinator@oic.wa.gov.

OIC has scheduled an interested parties meeting for July 12, 2022 at 9 a.m. via zoom. Interested parties can register to participate in the meeting here.

For more information, including the notice to start rulemaking (CR-101), please visit the rule’s webpage.