wa-26-21-071: Health, Department of — WSR 26-21-071

WSR 26-21-071 (26-21)WSR 26-21-071PROPOSED RULESDEPARTMENT OF HEALTH[Filed October 20, 2026, 8:24 a.m.]Original Notice.Preproposal statement of inquiry was filed as WSR 26-16-015.Title of Rule and Other Identifying Information: The department of health (department) is proposing rule amendments to update fees for ambulatory surgical facilities (ASF), WAC 246-330-199. The department is also proposing changes to clarify and standardize language.Hearing Location(s): On December 1, 2026, at 2:00 p.m. Register in advance for this webinar at https://us02web.zoom.us/webinar/register/WN_T3QxW0xHSn-gPbPbOo7LZg. After registering, you will receive a confirmation email containing information about joining the webinar.Date of Intended Adoption: December 8, 2026.Submit Written Comments to: Heather Cantrell, P.O. Box 47850, Olympia, WA 98504-7850, web https://fortress.wa.gov/doh/policyreview/, beginning the date and time of this filing, by December 1, 2026, at 11:59 p.m.Assistance for Persons with Disabilities: Contact Heather Cantrell, phone 360-236-4637, TTY 711, email HSQAFeeRules@doh.wa.gov, by November 17, 2026.Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The department is proposing amendments to a section of rule regarding initial license, renewal, and other fees for ASF to address funding requirements. An update is needed to adequately fund inspection, investigation, and licensing to protect patients. RCW 43.70.250 states that fees must cover regulatory program expenses, which requires a program to be self-funding. Changes to rules are the only way to make fee adjustments. Additionally, language and formatting have also been corrected for uniformity among the rules.Reasons Supporting Proposal: RCW 43.70.250 states that fees must cover regulatory program expenses, which requires a program to be self-funding. Changes to rules are the only way to make fee adjustments. Application volumes remain relatively low and stable, indicating limited growth in new facilities entering the program. Similarly, the number of active licensed facilities has also remained stable. However, increase in expenses is primarily driven by staffing investments needed to support inspections and investigations. Licensing, enforcement, policy, and program administration activities have also added to the need to increase fees. The proposed fees will address the costs and the reserve amounts needed. The department will continue to monitor the finances and propose fee adjustments as needed.Statutory Authority for Adoption: RCW 43.70.110, 43.70.250, and 70.230.020.Statute Being Implemented: RCW 43.70.110, 43.70.250, and 70.230.020.Rule is not necessitated by federal law, federal or state court decision.Name of Proponent: Department of health, governmental.Name of Agency Personnel Responsible for Drafting: Heather Cantrell, 111 Israel Road S.E., Tumwater, WA 98501; Implementation and Enforcement: Julie Tomaro, 111 Israel Road S.E., Tumwater, WA 98501, 360-236-4637.A school district fiscal impact statement is not required under RCW 28A.305.135.A cost-benefit analysis is not required under RCW 34.05.328. RCW 34.05.328 (5)(b)(vi) exempts rules that set or adjust fees or rates pursuant to legislative standards and RCW 34.05.328 (5)(b)(iv) exempts rules that only correct typographical errors or clarify language of a rule without changing its effect.This rule proposal, or portions of the proposal, is exempt from requirements of the Regulatory Fairness Act because the proposal: Is exempt under RCW 19.85.025(3) as the rules only correct typographical errors, make address or name changes, or clarify language of a rule without changing its effect; and rules set or adjust fees under the authority of RCW 19.02.075 or that set or adjust fees or rates pursuant to legislative standards, including fees set or adjusted under the authority of RCW 19.80.045.Explanation of exemptions: The proposed rules adjust fees and therefore are exempt under RCW 34.05.310 (4)(f). Additional clarifications are exempt under RCW 34.05.310 (4)(d).Scope of exemption for rule proposal:Is fully exempt.October 19, 2026Kristin Peterson, JDChief of Policyfor Dennis E. WorshamSecretary of HealthRDS-7406.2AMENDATORY SECTION(Amending WSR 19-02-044, filed 12/26/18, effective 4/15/19)WAC 246-330-199Fees—License, change of ownership, refund process.This section establishes the initial and renewal license fees, change of ownership fee, late fee, and request for refund of an initial license fee for an ambulatory surgical facility (ASF).(1) Initial and renewal license fees. An initial license or a renewal license and fee are valid for three years from date of issuance. An applicant for an initial or renewal license must submit one of the following fees to the department:ambulatory surgical facility initial and renewal feesFee TypeFeesInitial and RenewalLicensePerforms1,000 or Fewer SurgicalProcedureson anAnnual BasisPerforms1,001 - 5,000 SurgicalProcedureson anAnnual BasisPerformsMore than 5,000 Surgical Procedureson anAnnual BasisAccredited or Medicare Certified(($12,900))$20,000(($16,000))$25,000(($19,650))$30,500State Licensed Only(($17,550))$27,000(($22,000))$34,000(($27,200))$42,000(a) Accredited means an ASF is accredited by one of the organizations identified in WAC 246-330-025 (1)(b).(b) Medicare certified means an ASF is certified by the Centers for Medicare and Medicaid Services (CMS).(c) State licensed only means an ASF that is not accredited and is not medicare certified.(2) Late fee. A licensee must send the department a late fee in the amount of ((fifty dollars))$50 per day, not to exceed ((one thousand dollars))$1,000, whenever the renewal fee is not paid by ((thirty))30 days before the license expiration (date as indicated by the postmark).(3) Change of ownership. The change of ownership fee is good for that transaction and does not change the original license ending date. The person purchasing or taking over ownership of a licensed ASF must:(a) Send the department a change of ownership fee in the amount of ((five hundred dollars thirty))$800 at least 30 days before the change of ownership becomes final (date as indicated by the postmark); and(b) Receive from the department a new license valid for the remainder of the current license period.(4) An applicant may request a refund for initial licensure as follows:(a) Two-thirds of the initial fee paid after the department has received an application but has not conducted an on-site survey or provided technical assistance and has not issued a license; or(b) One-third of the initial fee paid after the department has received an application and has conducted either an on-site survey or provided technical assistance but not issued a license.