Regulatory Priorities

Bills that are signed into law, as well as executive orders, often require rulemaking for implementation. State agencies, boards, and commissions and the federal government use rulemaking to decide the finer details of policy changes required by legislation or executive order. These details may ultimately decide how the policy change impacts physicians, physician assistants, and practices. The WSMA policy team both monitors and engages on rules impacting the house of medicine.

WSMA Regulatory Priorities Update

The 2024 rulemaking season is coming to an end and several WSMA priorities are moving forward. Bills that are signed into law, as well as executive orders, often require rulemaking for implementation to decide the finer details of policy changes. These details may ultimately decide how the policy change impacts physicians, practices, and patient care delivery. The WSMA policy team monitors and engages on rules from a host of state agencies impacting the house of medicine.

Department of Health to issue final recommendations on naturopathy sunrise

The WSMA partnered with the Washington Osteopathic Medical Association and physician specialty societies on a final comment letter to the Department of Health, supporting the department's draft report rejecting the naturopaths' scope of practice proposal, accurately noting that it doesn't stipulate sufficient education/training to protect patient safety, would grant vague authority to naturopaths to provide in-clinic procedures to patients, and doesn't allow for appropriate care coordination (among other considerations).

The final report will be delivered to the Legislature in advance of the 2025 legislative session that begins in January. As this sunrise review ends, we want to thank all of you who have engaged in opposition to the proposal.

Board of Optometry advances scope of practice rulemaking, Washington Medical Commission drafting interpretive statement on "qualified physician"

In 2023, the Legislature approved Senate Bill 5389 concerning optometry scope of practice. Among other provisions, the bill allows optometrists to perform some "advanced procedures" and expands their prescriptive authority. The Board of Optometry is writing new rules, as well as updating current rules, to reflect these changes. The WSMA is working with the Washington Academy of Eye Physicians and Surgeons to advocate for the law to be implemented in line with legislative intent and to protect patient safety.

While the latest draft rule advanced by the board did not fully reflect feedback from WAEPS and WSMA, the Washington Medical Commission is currently drafting an interpretive statement to promote patient safety. The legislation requires an optometrist performing advanced procedures to partner with a "qualified physician" to respond to adverse events that may arise. The board interprets a "qualified physician" to be an allopathic or osteopathic physician of any specialty. The WMC, WAEPS, and WSMA interpret a "qualified physician" to be a board-certified ophthalmologist, and the interpretive statement reflects that position and, if approved, will serve as guidance to all physician licensees.

Washington Medical Commission workshopping office-based nitrous oxide rules

The Washington Medical Commission has issued a CR-101 specific to the rules governing the use of nitrous oxide in office-based settings, and held two stakeholder workshops specific to this rule. The WSMA supports increased flexibility for physicians while ensuring that patient safety is maintained. We have shared our support in person and via written comments.

Anesthesiologist assistant rulemaking begins

The Washington Medical Commission has begun rulemaking implementing Senate Bill 5184, establishing licensure for anesthesiologist assistants. The bill creates a new anesthesiologist assistant profession under the umbrella of the commission. Working in partnership with the Washington State Society of Anesthesiologists, the WSMA supported this legislation and has submitted a comment supportive of the draft language issued by the WMC.

Pharmacy Quality Assurance Commission accessible labels rules advancing

The state Pharmacy Quality Assurance Commission is conducting an accessible label rulemaking to ensure that patients have access to critical information about prescription drugs. This rule will be applicable to pharmacies, as well as to physicians and physician assistants who dispense medication. While the WSMA is supportive of the rule, we requested an exemption for sample medications. The CR-102 issued and approved by the PQAC accommodated that request. The rule will take effect 24 months after the CR-103 is filed.

WSMA Member Support Available

Do you have questions about how changes from the state legislative session will apply to your practice? Are you frustrated by administrative burden or a particular state or federal regulation? The WSMA Policy Department is here to help. As a WSMA member, you have access to policy experts who can assist with your questions and provide information on the latest health care policies and proposals. Your questions and feedback help us shape our policy agenda in partnership with the House of Delegates, our legislative team, and state and federal agencies, and may lead to direct WSMA-led action before the state to address issues facing physicians.

We need to hear from you! Reach out to us with your questions and ideas at policy@wsma.org.