Around the PIA Western Alliance States – Week of April 22, 2024

California — Appointments to Curriculum Board and the Insurance Diversity Task Force: Insurance Commissioner Ricardo Lara announced several appointments to help advance the California Department of Insurance’s vision of insurance protection for all Californians. These appointments include naming Aretha Hartley as the newest member of the Curriculum Board, and reappointed members Pradip Khemani, Jose Plascencia and Vikita Poindexter.

“I am pleased to announce these appointments to the Curriculum Board and the Insurance Diversity Task Force,” said Commissioner Lara. “Californians will benefit from their advice on how we can continue to protect consumers and ensure a healthy and diverse insurance industry in our state.”

The Curriculum Board oversees the development of pre-licensing and continuing education curriculum for agents and brokers to uphold professional standards that protect consumers. This includes a list of preapproved courses of study as well as courses of study for professional designations. This Board also develops standards for providers and instructors who offer courses and other training to licensed agents and brokers.

The Insurance Diversity Task Force oversees the Department’s Insurance Diversity Initiative, which encourages insurers to advance diversity of insurance company corporate boards and increase procurement contracts with diverse businesses owned by women, veterans and disabled veterans, members of historically disadvantaged communities, and LGBTQ+ people. Additionally, the Task Force makes recommendations to the Commissioner regarding innovative ways to increase diversity within the insurance industry. Last year, Commissioner Lara introduced the first-ever Insurance Diversity Index, a groundbreaking benchmarking tool for a more inclusive insurance industry.

The next Curriculum Board meeting is July 18, 2024 and the next Insurance Diversity Task Force meeting is June 20, 2024. More details are available at: www.insurance.ca.gov/boards. All positions are uncompensated.

Washington — Technical Assistance Advisory 2024-02: The Use of Artificial Intelligence Systems in Insurance: We recently published Technical Assistance Advisory 2024-02: The Use of Artificial Intelligence Systems in Insurance. The purpose of this Technical Assistance Advisory (“TAA”) is to remind all Insurers that hold certificates of authority to do business in the state that decisions or actions impacting consumers that are made or supported by advanced analytical and computational technical, including Artificial Intelligence(AI) Systems, must comply with all applicable insurance laws and regulations.

For more information, including other TAAs, please visit the technical assistance advisories and emergency orders webpage — https://bit.ly/3WcVFxd

Washington — Technical Assistance Advisory 2024-01: OIC’s Interpretation of Chap. 48.200 RCW & RCW 48.43.731 – Health care benefit managers: We recently published Technical Assistance Advisory 2024-01: OIC’s Interpretation of Chap. 48.200 RCW & RCW 48.43.731 – Health care benefit managers. The purpose of this Technical Assistance Advisory (“TAA”) is to provide guidance to health carriers on the Office of Insurance Commissioner (“OIC”)’s response to the Change Healthcare cybersecurity event that occurred on February 21, 2024, and the duties of health carriers and health care benefit managers under Chap. 48.200 RCW and Chap. 284-180 WAC.

For more information, including other TAAs, please visit the technical assistance advisories and emergency orders webpage — https://bit.ly/3WcVFxd

Washington — ChangeHealth Breach Update: Washington state Insurance Commissioner Mike Kreidler’s office has issued a Technical Assistance Advisory (TAA) (PDF, 326.04 KB) to all state health insurers as part of its ongoing response to the recent Change Healthcare cybersecurity event.

The TAA advises health insurers and health care benefit managers that any health care benefit managers they use must be registered with the Office of the Insurance Commissioner (OIC) to conduct business in Washington state. The legislature passed a law in 2020 requiring health care benefit managers to be registered with the state because these companies make decisions that impact whether consumers can access needed care and whether health care providers will be paid for their services. Additionally, health insurers must submit direct and indirect contracts for health care benefit management services performed by these organizations.

“We have laws in place to protect consumers from harm,” said Kreidler. “This includes laws that prohibit unregulated entities from operating in Washington and making critical decisions impacting a patient’s access to needed care. Companies that do business here must register with my office and health insurers must provide the contracts for their services.”

The OIC has been informed that Change Healthcare, and other health care benefit manager business entities, are processing claims and reviewing consumers’ need for health services for several health insurers in Washington state. However, not all of these entities are registered with the OIC or have filed their contracts with the OIC.

Change Healthcare, a subsidiary of United Health Group that also operates Optum Solutions, encountered a cybersecurity event on Feb. 21, 2024, that compromised systems widely used by providers and insurers to fill prescriptions, approve medical services, and submit costs for reimbursement. The result has been delays for some patients in getting necessary medication and prior approvals for care. For some hospitals, independent health care providers, outpatient facilities and pharmacies across Washington, there have been delays and uncertainty in receiving payments.

The OIC subsequently issued three letters to health insurers operating in Washington requesting they provide copies of all executed and active health care benefit manager contracts with Change Healthcare, Inc.

In the TAA, the OIC identified multiple entities as contracting to provide health care benefit management services as corporate partners or affiliates of Change Healthcare. These include EquiClaim, RelayHealth, Emdeon, Optum Rx, OptumInsight, and McKesson.

About PIA Western Alliance

The Professional Insurance Agents Western Alliance is a membership organization promoting and enhancing the success of independent agencies seeking to grow, learn and be heard within the industry.


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