The Department of Labor & Industries (L&I) updated its rulemaking website
Rules filed January 16 and January 21, 2025
For information on all L&I meetings and public hearings related to rulemaking, please visit our public participation calendar.
Division: Insurance Services (Health Services Analysis)
Topic: Adoption (CR-103) – Physician Assistant Billing Procedure (repeal)
Brief Description: This rulemaking repeals WAC 296-20-12501 in its entirety. WAC 296-20-12501 requires physician assistants to be paid at 90% of the value listed in the fee schedule for services they perform. This change allows L&I to pay physician assistants at parity with other providers. The pay differential in rule was put in place when physician assistants were exclusively supervised by other providers. Due to the passage of Engrossed Substitute House Bill 2041 (ESHB 2041), Chapter 62, Laws of 2024, physician assistants may now practice autonomously in collaborative agreements. Therefore, it no longer makes sense to pay them less than other providers who practice independently.
Effective date: March 1, 2025
Additional information about this rulemaking:
CR-103 Repeal
Repealer Language
Final Cost Benefit Analysis (CBA)
Concise Explanatory Statement (CES)
Division: Insurance Services (Legal Services)
Topic: Adoption (CR-103) – Pension Discount Rate 2025
Brief Description: The purpose of this rulemaking is to lower the pension discount rate (PDR) under WAC 296-14-8810 to better align with the rate of return for long term treasuries for self-insured pensions. The PDR is the interest rate used to account for the time value of money when evaluating the present value of future pension payments. This rule lowers the PDR for self-insured employers from 5.5% to 5.4%.
Effective date: April 1, 2025
Additional information about this rulemaking:
CR-103 Adoption
Adoption Language
Concise Explanatory Statement (CES)
Division: Insurance Services (Office of the Medical Director)
Topic: Proposal (CR-102) – Psychologists as Attending Providers (HB 1197 Implementation)
Brief Description: The purpose of this rulemaking is to implement House Bill 1197 (Chapter 171, Laws of 2023), Defining attending provider and clarifying other provider functions for workers' compensation claims, and adding psychologists as attending providers for mental health only claims. HB 1197 indicates who can be attending providers on Washington’s workers’ compensation claims. It includes providers who are already in the definition of “attending provider” in WAC 296-20-01002 Definitions, and adds “psychologists in the case of claims solely for mental health conditions, and physician assistants”. To reflect that change L&I is proposing to add those two provider types to the definition of “attending provider” in WAC 296-20-01002 and to other applicable WACs in Title 296 WAC.
L&I is also proposing amendments to Title 296 WAC for clarity and for consistency with HB 1197. One example is that the current rule on the “Attending provider report” requires the condition(s) diagnosed including the current federally adopted International Classification of Diseases, Clinically Modified (ICD-CM) codes. The proposed rule clarifies that, for a mental health condition(s), the report must also include the condition(s) diagnosed using the edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM) designated by L&I. While this is new to the “attending provider report”, it reflects current practice.
In addition, L&I is proposing to amend WAC 296-20-01501 Physician assistant rules to align language with Engrossed Substitute House Bill 2041 (Chapter 62, Laws of 2024), Physician assistant collaborative practice, and the Department of Health/Washington Medical Commissions’ corresponding rule updates to Chapter 246-918 WAC. ESHB 2041 authorizes physician assistants to engage in a collaborative practice where a written agreement describes the manner in which the physician assistant is supervised by or collaborates with at least one physician. Examples of language L&I is proposing include a reference to physician assistants working under a collaboration agreement as defined in the Department of Health statute RCW 18.71A.010, and other amended language on credentialing.
Public hearing date: February 26, 2025 (Tumwater/virtual/phone)
Written comments due by: February 28, 2025, 5:00 p.m.
Intended adoption date: May 20, 2025
Additional information about this rulemaking:
CR-102 Proposal
Proposal Language
Preliminary Cost Benefit Analysis (CBA)
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