A New Year Means New Rules and Guidelines
As we hit the ground running in 2022, there are few rule changes to keep in mind when administering claims in Washington. I’ve included a summary of the several changes and updates to keep in mind.
Heading into January 2022, the Department has extended its emergency rule related to employer COVID-19 reporting. The emergency rule was previously extended in August 2021 and governs employers of more than 50 workers and the reporting of COVID-19 infections to the Department. Employers can reference WAC 296-62-600, WAC 296-62-601 and the Department’s website for additional details.
As of January 1, 2022, the Department has updated their list of approved medications in their Outpatient Drug Formulary, with five new drug classes added to the prior list. The entire document can be found at https://lni.wa.gov/patient-care/_docs/DrugFormulary.pdf and a search for the term “New Drug Class” within the document will help locate the new information.
Effective January 1, 2022, the Department has updated prior authorization requirements for massage therapy. Now services provided by a massage therapist require prior authorization after the 6th visit. When considering whether to provide authorization for additional visits, it is helpful to remember the reporting requirements for massage therapist as well, including the requirements to submit detailed progress reports after every six visits or monthly, whichever occurs first. Failure to submit progress reports is a basis to deny bills and/or deny authorization for further treatment. Additional information is located on Fee Schedules and Payment Policies (MARFS) page on the Department’s website.
Finally, just before the end of the year, the Department of Labor & Industries extended certification requirements for all claims administrators through June 30, 2022. The extension was given due to delays in implementation and enforcement of certification requirements. Please note certain conditions apply and a review of Department’s website is recommended for further information.
If you have any questions about any rule change as we head into the new year, please do not hesitate to contact me at or 503-595-6111.
Posted by: Sarah Cohen.