# WAC 284-43A-050: WAC 284-43A-050. Conflict of interest > Washington · Regulations · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_050 ## Section - **Citation:** WAC 284-43A-050 - **Heading:** WAC 284-43A-050. Conflict of interest - **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-050 ## Text (1) An IRO: (a) Must not be a subsidiary of, or in any way owned or controlled by, a carrier or an association of health care providers or carriers; (b) Shall provide information to the commissioner on its own organizational affiliations and potential conflicts of interest at the time of application and when material changes occur; (c) Shall immediately turn down a case referred by the commissioner if accepting it would constitute an organizational conflict of interest; and (d) Shall ensure that reviewers are free from any actual or potential conflict of interest in assigned cases. (2) An IRO, as well as its reviewers, must not have any material familial, professional, or financial affiliation, as defined in WAC 284-43A-010 , with the health carrier, enrollee, enrollee's provider, that provider's medical or practice group, the facility at which the service would be provided, or the developer or manufacturer of a drug or device under review. An affiliation with any director, officer or executive of an IRO must be considered to be an affiliation with the IRO. (3) The following do not constitute violations of this section: (a) Staff affiliation with an academic medical center or National Cancer Institute-designated clinical cancer research center; (b) Staff privileges at a health care facility; (c) Maintaining a provider contract with a carrier which provides no more than five percent of the provider's or clinical group's annual revenue; or ith the IRO. (3) The following do not constitute violations of this section: (a) Staff affiliation with an academic medical center or National Cancer Institute-designated clinical cancer research center; (b) Staff privileges at a health care facility; (c) Maintaining a provider contract with a carrier which provides no more than five percent of the provider's or clinical group's annual revenue; or (d) An IRO's receipt of a carrier's payment for independent re-views assigned by the commissioner under RCW 48.43.535 . (4) Notwithstanding the provisions of subsection (3) of this section, a potential reviewer must be considered to have a conflict of interest with regard to a facility or health plan, regardless of revenue from that source, if the potential reviewer is a member of a standing committee of: The facility, the health plan, or a provider network that contracts with the health plan. (5) A conflict of interest may be waived only if both the enrollee and the health plan agree in writing after receiving full disclosure of the conflict, and only if: (a) The conflict involves a reviewer, and no alternate reviewer with necessary special expertise is available; or (b) The conflict involves an IRO and the commissioner determines that seeking a waiver of conflict is preferable to reassigning the review to a different IRO. ## 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) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_ADC_284_43A_050. Check the current official text before relying on it. Not legal advice.