"Benefits under this contract will not be denied for any health care service performed by a registered nurse licensed to practice under Every chapter 18.88 RCW, if first, the service performed was within the Category of lawful scope of such nurse's license, and second, this contract Provider would have provided benefits if such service had been performed (Cont’d) by a doctor of medicine licensed to practice under chapter 18.71 RCW." WAC The contract may not contain a provision which places restrictions or 284-44-045(4) limitations on benefits for services by nurses or any class of doctors which are not also placed on benefits for services by other doctors. E.g., plan may not limit the number of office calls made to a RN to fewer than the limit for office calls made to a MD. Coverage of 48.43.190 Plan must chiropractic care on the same basis as other care. Chiropractic RCW 48.44.310 Benefits cannot be denied on the that a service is not performed care by a physician licensed under Chapter 18.57 or 18.71 RCW. WAC Must provide direct access to a chiropractor without a referral for covered chiropractic benefits, but can restrict this to in-network chiropractors.
Every Category of Provider (Cont’d) "Benefits under this contract will not be denied for any health care service performed by a registered nurse licensed to practice under chapter 18.88 RCW, if first, the service performed was within the lawful scope of such nurse's license, and second, this contract would have provided benefits if such service had been performed by a doctor of medicine licensed to practice under chapter 18.71 RCW." WAC 284-44-045(4) The contract may not contain a provision which places restrictions or limitations on benefits for services by nurses or any class of doctors which are not also placed on benefits for services by other doctors. E.g., plan may not limit the number of office calls made to a RN to fewer than the limit for office calls made to a MD. Coverage of Chiropractic care 48.43.190 Plan must chiropractic care on the same basis as other care. RCW 48.44.310 Benefits cannot be denied on the that a service is not performed by a physician licensed under Chapter 18.57 or 18.71 RCW. WAC Must provide direct access to a chiropractor without a referral for covered chiropractic benefits, but can restrict this to in-network chiropractors.
checklist-forms-2018-hcsc-small-group-analyst-checklist.docx