(1) The director shall supervise the providing of
prompt and efficient care and treatment, including care provided
by physician assistants governed by the provisions of chapters 18.57A and 18.71A RCW, acting under a supervising physician,
including chiropractic care, and including care provided by
licensed advanced registered nurse practitioners, to workers
injured during the course of their employment at the least cost
consistent with promptness and efficiency, without discrimination
or favoritism, and with as great uniformity as the various and
diverse surrounding circumstances and locations of industries
will permit and to that end shall, from time to time, establish
and adopt and supervise the administration of printed forms,
rules, regulations, and practices for the furnishing of such care
and treatment: PROVIDED, That the medical coverage decisions of
the department do not constitute a "rule" as used in RCW 34.05.010(16), nor are such decisions subject to the rule-making
provisions of chapter 34.05 RCW except that criteria for
establishing medical coverage decisions shall be adopted by rule
after consultation with the workers' compensation advisory
committee established in RCW 51.04.110: PROVIDED FURTHER, That
the department may recommend to an injured worker particular
health care services and providers where specialized treatment is
indicated or where cost effective payment levels or rates are
obtained by the department: AND PROVIDED FURTHER, That the
department may enter into contracts for goods and services
including, but not limited to, durable medical equipment so long
as statewide access to quality service is maintained for injured
workers.
(2) The director shall, in consultation with interested
persons, establish and, in his or her discretion, periodically
change as may be necessary, and make available a fee schedule of
the maximum charges to be made by any physician, surgeon,
chiropractor, hospital, druggist, licensed advanced registered
nurse practitioner, physicians' assistants as defined in chapters 18.57A and 18.71A RCW, acting under a supervising physician or
other agency or person rendering services to injured workers.
The department shall coordinate with other state purchasers of
health care services to establish as much consistency and
uniformity in billing and coding practices as possible, taking
into account the unique requirements and differences between
programs. No service covered under this title, including
services provided to injured workers, whether aliens or other
injured workers, who are not residing in the United States at the
time of receiving the services, shall be charged or paid at a
rate or rates exceeding those specified in such fee schedule, and
no contract providing for greater fees shall be valid as to the
excess. The establishment of such a schedule, exclusive of
conversion factors, does not constitute "agency action" as used
in RCW 34.05.010(3), nor does such a fee schedule constitute a
"rule" as used in RCW 34.05.010(16).
(3) The director or self-insurer, as the case may be, shall
make a record of the commencement of every disability and the
termination thereof and, when bills are rendered for the care and
treatment of injured workers, shall approve and pay those which
conform to the adopted rules, regulations, established fee
schedules, and practices of the director and may reject any bill
or item thereof incurred in violation of the principles laid down
in this section or the rules, regulations, or the established fee
schedules and rules and regulations adopted under it.
[2004 c 65 § 1; 1998 c 230 § 1; 1997 c 325 § 2; 1994 c 164 § 25. Prior: 1993 c 515 § 1; 1993 c 159 § 1; 1989 c 189 § 1; 1986 c 200 § 8; 1980 c 14 § 1; prior: 1977 ex.s. c 350 § 2; 1977 ex.s. c 239 § 1; 1971 ex.s. c 289 § 74; 1961 c 23 § 51.04.030; prior: (i) 1917 c 28 § 6; RRS § 7715. (ii) 1919 c 129 § 3; 1917 c 29 § 7; RRS § 7716. (iii) 1923 c 136 § 10; RRS § 7719.]
NOTES:
Report to legislature -- 2004 c 65: "By December 1, 2006, the department of labor and industries shall report to the senate committee on commerce and trade and the house committee on commerce and labor, or successor committees, on the implementation of this act, including but not limited to the effects of this act on injured worker outcomes, claim costs, and disputed claims." [2004 c 65 § 17.]
Effective date -- 2004 c 65: "This act takes effect July 1, 2004." [2004 c 65 § 18.]
Severability -- 2004 c 65: "If any provision of this act or its application to any person or circumstance is held invalid, the remainder of the act or the application of the provision to other persons or circumstances is not affected." [2004 c 65 § 20.]