Prenatal Tests Rule Adopted by Board, Effective Date July 1, 2022

The Washington State Board of Health (Board) voted to adopt the proposed amendments to the state’s Prenatal Tests, Congenital and Hereditary Disorders rule at its June 9 public meeting. The rule now enters the adoption phase. Staff filed a CR-103 rulemaking order, which records the Board’s action to officially adopt the rule and notifies the public of the newly adopted rule. The rulemaking order is filed with the state’s code reviser’s office for publication in the Washington State Register. The new rule has an effective date of July 1, 2022.

Benefits for prenatal diagnosis of congenital disorders (RCW 48.21.244, 48.44.344, 48.46.375) state that certain insurers, health care service contractors, and health maintenance organizations which offer coverage for hospital, medical, or surgical expenses and provides benefits for pregnancy, childbirth, or related medical conditions must cover benefits for medically necessary prenatal diagnosis of congenital disorders by screening and diagnostic procedures in accordance with standards established by the Board.

The prenatal tests for congenital and heritable disorders rule establishes these standards in determining medical necessity for screening and diagnostic procedures for diagnosis of congenital disorders of a fetus. The Board last updated chapter 246-680 WAC in 2003. Since then there have been advances in medical science and additional evidence regarding prenatal tests is available.

The proposed rule would update the standards established by the Board for benefits to include all those that meet current standards of practice and are medically indicated. It removes restrictive criteria for certain tests, includes new tests, and makes editorial changes to improve the usability of the rule. Recommendations for standards of care published by national organizations provided guidance for updates to criteria for certain tests and the inclusion of new tests. Read more about the rule on the prenatal tests rule web page or the June 9 public meeting web page