Section 284-43B-029 - Local governmental entity rate reporting to the insurance commissioner(1) Each local governmental entity that has established rates for ground ambulance services provided in their geographic area must submit the rates to the office of the insurance commissioner in the form and manner prescribed by the commissioner. Rates established for ground ambulance transports include rates for services provided directly by the local governmental entity and contracted rates.(2) Local governmental entities must include the following rate information in their submission to the commissioner for each locally set rate or contracted rate submitted to the commissioner:(a) The local governmental entity's full legal name and address;(b) The national provider identifier(s) (NPI) for any ground ambulance services organization to which the rate applies;(c) The effective date of the rate and any known expiration date of the rate;(d) The service area of the local governmental entity, described by listing the geographic zone improvement plan (ZIP) codes established by the United States Postal Service that are included in the entity's service area;(e) The applicable transport codes to which the rate applies, including any separate mileage code or codes;(f) If applicable, the locally set rate for services provided to nonresidents of the local governmental entity's service area, if a distinction is made in rates between services provided to residents and those provided to nonresidents.(3) The information must be submitted electronically through the website of the office of the insurance commissioner.(4) Local governmental entities must submit their rates to the commissioner on the following schedule:(a) Updated rates must be submitted by November 1st for an effective date of January 1st of the following year.(b) A rate may be updated by a local governmental entity outside of the time frame established in (a) of this subsection if the local governmental entity finds that there is an emergent risk to the financial viability of the ground ambulance services organization if the rate update is delayed to a January 1st effective date. To apply for rate update exception a local governmental entity must: (i) Follow their local rate setting rules and procedures and be approved in the manner prescribed by their governing entity.(ii) Allow 60 days from approval of the new rate to its effective date.(iii) Submit the updated rate to the office of the insurance commissioner at least 30 days prior to its effective date.(5) For purposes of this section "contracted rates" means rates established in a contract or contracts between a local governmental entity and a private ground ambulance services organization to provide ground ambulance services in their geographic service area.Wash. Admin. Code § 284-43B-029
Adopted by WSR 24-24-065, Filed 11/27/2024, effective 12/28/2024