Around the PIA Western Alliance States

Oregon — Pharmacy Representative Licensing Rules: The Oregon Division of Financial Regulation recently announced the following proposed rulemaking:

FILING CAPTION: Pharmaceutical Representative Licensing Rules

NEED FOR THE RULE(S):

The rules promulgate definitions to facilitate the administration of the program, define procedures for licensure

application and renewal, specify prohibited conduct and penalties for licensees, define expectations for the continuing

education necessary to maintain licensure, define expectations for licensees to report information to DCBS, define

procedures for the registration of education providers, define procedures for the registration of education courses, and

define procedures for recording credit for continuing education.

Rules: 836-200-0600, 836-200-0605, 836-200-0610, 836-200-0615, 836-200-0620, 836-200-0625, 836-200-0630, 836-200-0635, 836-200-0640, 836-200-0645, 836-200-0650, 836-200-0655, 836-200-0660, 836-200-0670

Filed: April 26, 2022 

Hearing: May 23, 2022, 11:00 A.M.

 Microsoft TEAMS meeting:

Call in (audio only)

+1 503-446-4951,,967652967# United States, Portland

Phone Conference ID: 967 652 967#

Last day/time to offer comment: May 27, 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/20220523-Pharm-Reps-Licensing.pdf

Oregon — Intentional Acts Exclusions: The Oregon Division of Financial Regulation has issued a bulletin regarding guidance on policy language used in intentional acts exclusions.  

Purpose

The purpose of this bulletin is to provide property and casualty insurers with guidance on policy language used to exclude coverage of intentional acts.

Exclusionary language that applies to losses beyond what the insured intended encompasses not only intentional acts but could exclude coverage of negligence or unintended acts or harms. This is not how intentional acts exclusions have been interpreted by Oregon courts.

Exclusionary language, such as those that apply to “losses of a different kind, quality or degree than initially expected or intended” or to losses that are “sustained by a different person, entity, or property than initially expected or intended,” will be disapproved. Language conveying that an exclusion applies whether or not the insured had the requisite intent will also be disapproved.

Click here to review this bulletin:

https://dfr.oregon.gov/laws-rules/Documents/Bulletins/bulletin2022-02.pdf

Oregon — Health Plans Rulemaking: The Oregon Division of Financial Regulation recently announced the following proposed rulemakings:

Filing Caption: Amendment to 2023 standard bronze and silver health benefit plan

Amend: 836-053-0013

Rule Summary: Update standard bronze and silver plans.

Filing Caption: Adoption of insulin cost-sharing rule

Adopt: 836-053-0025

Rule Summary: Regulation of the insulin co-pay amount for health benefit plans.

Filed: April 29, 2022

Hearing for both rulemakings: May 23, 2022, 1:30 PM

Microsoft TEAMS meeting:

Call in (audio only)

+1 503-446-4951,,519267807# United States, Portland

Phone Conference ID: 519 267 807#

Last day/time to offer comment: May 27, 2022, 5:00 PM

For more information on this recently adopted rule, please visit the division’s website:

https://dfr.oregon.gov/laws-rules/Pages/proposed-rules.aspx

Washington — Memoranda for behavioral health community and interest parties: OIC prepared two memoranda for the behavioral health community and other interested parties. One describes the provisions of E2SHB 1688 regarding coverage of behavioral health crisis services by health insurance plans. The other provides an analysis of that coverage in the context of the federal Mental Health Parity and Addiction Equity Act and the federal No Surprises Act.

Both documents can be found on the OIC surprise billing website — https://www.insurance.wa.gov/federal-no-surprises-act?utm_content=&utm_medium=email&utm_name=&utm_source=govdelivery&utm_term=

Washington — It’s never too early to prepare for wildfires: Saturday, May 7 was National Wildfire Community Preparedness Day.

With wildfire season already underway, it’s not too early to get ready. Consider these tips to get started:

Work with your insurance agent or company to review your insurance coverage. Do you have the right coverage and enough to rebuild?

If you’re renting, consider buying renters insurance to protect your personal belongings. Many policies cost around $15 a month.

Create a home inventory. Take photos or videos of your belongings in each room of your home. Store the inventory in the cloud or in a location away from your home.

Make copies of important identifying and financial documents, including identification and Social Security cards, titles, insurance policy information, tax records, and pet records.

Build an emergency kit.

Here is a link to more information — https://medium.com/commissioners-eye-on-insurance/its-never-too-early-to-prepare-for-wildfires-4b761251dad3

Washington — Notice of rulemaking on Implementation of E2SHB 1688 (R 2022-02): We are starting rulemaking (R 2022-02) to implement Chap. 263, Laws of 2022. This law amends state law related to health carrier coverage of emergency services, the Balance Billing Protection Act (BBPA) and network access provisions for services subject to the balance billing prohibition under the BBPA. Rulemaking is necessary to revise the Balance Billing Protection Act rules at chapter 284-43B WAC and OIC network access rules at chapter 284-170 WAC to be consistent with the new law. The rules will facilitate implementation of the law by ensuring that all affected entities understand their rights and obligations under the new law.

Comments are due May 31, 2021; please send them to rulescoordinator@oic.wa.gov.

OIC has scheduled an interested parties meeting for May 25, 2022 at 3:30 p.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.