# WAC 284-43A-001: WAC 284-43A-001. Purpose and scope

> Washington · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_001

## Section

- **Citation:** WAC 284-43A-001
- **Heading:** WAC 284-43A-001. Purpose and scope
- **Jurisdiction:** Washington
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Administrative Code / Title 284 / Chapter 284-43A / Section 284-43A-001

## Text

(1) Purpose. These rules are adopted by the Washington state office of the insurance commissioner to implement the provisions of RCW 48.43.535 regarding the certification and requirements of independent review organizations (IROs) and requirements for carriers referring review of adverse benefit determinations to IROs. Certified IROs are qualified to receive referrals from the commissioner or designee under RCW 48.43.535 to make binding determinations related to health care coverage and payment disputes between health insurance carriers and their enrollees.
(2) Other applicable rules. Independent review is also subject to rules of the commissioner implementing RCW 48.43.535 .
(3) Applicability. These rules apply to independent review cases originating in Washington state under RCW 48.43.535 , and to independent review organizations conducting these reviews.

## Nearby sections

- [WAC 284-43A-001 WAC 284-43A-001. Purpose and scope](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_001.md)
- [WAC 284-43A-010 WAC 284-43A-010. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_010.md)
- [WAC 284-43A-020 WAC 284-43A-020. General requirements for certification](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_020.md)
- [WAC 284-43A-030 WAC 284-43A-030. Application for certification as an IRO](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_030.md)
- [WAC 284-43A-040 WAC 284-43A-040. Administrative processes and capabilities of IROs](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_040.md)
- [WAC 284-43A-050 WAC 284-43A-050. Conflict of interest](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_050.md)
- [WAC 284-43A-060 WAC 284-43A-060. Expert reviewers](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_060.md)
- [WAC 284-43A-070 WAC 284-43A-070. Independent review process](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_070.md)
- [WAC 284-43A-080 WAC 284-43A-080. Criteria and considerations for independent review determinations](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_080.md)
- [WAC 284-43A-090 WAC 284-43A-090. Additional requirements for experimental or investigational treatment reviews](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_090.md)
- [WAC 284-43A-100 WAC 284-43A-100. Ongoing requirements for IROs](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_100.md)
- [WAC 284-43A-110 WAC 284-43A-110. Powers of the commissioner](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_110.md)
- [WAC 284-43A-120 WAC 284-43A-120. Grounds for action against an applicant or a certified IRO](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_120.md)
- [WAC 284-43A-130 WAC 284-43A-130. Maximum fee schedule](https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_130.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_001. Check the current official text before relying on it. Not legal advice.