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Regulatory Priorities

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.

2024 Regulatory Environment Takes Shape

The conclusion of the legislative session each spring marks the unofficial start to rulemaking season. Bills that are signed into law, as well as executive orders, often require rulemaking for implementation. State agencies, boards, and commissions use rulemaking to decide the finer details of policy changes required by legislation, executive order, or petition from the public. 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.

As agencies finalize their rulemaking agendas for the rest of 2024, the following are just a few of the priority rulemakings identified by the WSMA policy team.

Department of Health conducting a sunrise review of Senate Bill 5411 (naturopathic scope of practice)

The Department of Health is conducting a sunrise review of SB 5411 concerning the naturopathic scope of practice. Requested by the Legislature, a sunrise review is a comprehensive review of a scope of practice proposal. The department’s recommendations often inform future legislative action. The proposal currently under review would make updates to the naturopathic scope of practice, including:

  • Expanding prescriptive authority to include controlled substances schedules II-V. This change would include opioids.
  • Allowing a naturopath to sign and attest to any certification cards, forms, or required documents that a physician can sign.
  • Changing the definition of “minor office procedure” to include primary care services and treatment of minor injuries.

The WSMA has serious patient safety concerns about this proposal, and we have shared our opposition during both the written comment period and a public hearing on the issue. The Department of Health is expected to issue preliminary recommendations in early summer.

Board of Optometry implementing Senate Bill 5389 (optometry scope of practice)

In 2023, the Legislature approved SB 5389 concerning the optometry scope of practice. Among other things, 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 ensure legislative intent is maintained and, more importantly, protect patient safety.

Pharmacy Quality Assurance Commission conducting accessible label rulemaking

The state Pharmacy Quality Assurance Commission is conducting an accessible label rulemaking to ensure that every Washington patient has access to the critical health information they need. This rule will be applicable to physicians and physician assistants who dispense medication. While the WSMA is supportive of the rule, we requested an exemption for sample medications. The most recent draft of the rule accommodated that request.

Department of Health updating certificate of need rulemaking

The Department of Health has filed a CR-101 to open the entire chapter of Certificate of Need rules (246- 310 WAC) to clarify, streamline, develop progressive enforcement tools, and modernize language. As part of this process, the department will address petitions to work on hospice need forecasting methodology and standards, Percutaneous Coronary Intervention Volume standards, and other settings and services such as acute care and psychiatric bed need, kidney dialysis, home health, general rules, and others.

Washington Medical Commission, Board of Osteopathic Medicine and Surgery priority rulemakings underway

Office of the Insurance Commissioner conducting rulemakings on WSMA priorities

The Office of the Insurance Commissioner will continue rulemakings on several bills pertinent to the house of the medicine. The WSMA is paying close attention to the following rulemakings under the OIC’s jurisdiction:

  • The OIC will resume implementation of HB 1357, WSMA priority legislation intended to ease administrative burden associated with prior authorization. The WSMA has and will continue to advocate for the OIC to implement this bill to the full extent authorized by the Legislature.
  • The OIC has begun rulemaking implementing legislation adopted in the 2024 session (SB 5986) that extends state-level balance billing protections to services delivered via ground ambulances. The rulemaking may also impact provisions of WAC related to the state’s balance billing arbitration system.

This is just a small sample of the rulemakings the WSMA policy team is currently tracking. Should you have questions about rulemakings underway at the state level, please contact WSMA Associate Policy Director Billie Dickinson.

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.

Join or renew your membership today!