Washington Administrative Code
Title 182 - Health Care Authority
HEALTH TECHNOLOGY ASSESSMENT PROGRAM
Chapter 182-55 - Health technology assessment program
Section 182-55-035 - Committee coverage determination

(1) Determine the conditions, if any, under which the health technology will be included as a covered benefit in health care programs of participating agencies by deciding that:

(2) Identify whether the coverage determination is consistent with decisions made under the federal medicare program and expert treatment guidelines.

(3) For decisions that are inconsistent with either decisions made under the federal medicare program or expert treatment guidelines, including those from specialty physician and patient advocacy organizations, specify the substantial evidence regarding the safety, efficacy, and cost-effectiveness of the technology that supports the contrary determination.

(4) For covered health technologies, specify criteria for participating agencies to use when deciding whether the health technology is medically necessary or proper and necessary treatment.