DIR Fees Law – WASHINGTON
WASHINGTON SUMMARY OF EXISTING LAW
Effective January 1, 2022, a PBM (l) May not directly or indirectly retroactively deny or reduce a claim or aggregate of claims after the claim or aggregate of claims has been adjudicated, unless
Link to Exsisting Law: Wash. Rev. Code Ann. § 19.340.100
Practical Note for Exsisting Law
While not effective until 2022, this law is a standard clawback law and prohibits retrospective DIR fees. It must be noted that these requirements are limited to insurance plans regulated by the State, and may exclude Medicare Part D, TRICARE, and possibly ERISA-regulated plans.
