Rule-Making Activity

The Board of Osteopathic Medicine and Surgery is proposing amendments to update the examination requirements for licensure of osteopathic physicians in WAC 246-853-020.

The Board of Osteopathic Medicine and Surgery (board) adopted amendments in WAC 246-853-020 to update the examination requirements for licensure of osteopathic physicians, allowing applicants to select one out of the four nationally approved examination series instead of selecting a combination of two or more examinations to qualify for licensure. Additionally, the board removed the Osteopathic Principles and Practices exam as one of the examination options as this is an underutilized pathway to licensure.

The Board of Osteopathic Medicine and Surgery and the Washington State Department of Health (DOH) are proposing amendments to WAC 246-853-045 and WAC 246-853-21, and to repeal WAC 243-853-060, as a result of the review to clarify and update language.

The Board of Osteopathic Medicine and Surgery is considering amending WAC 246-853-661 Exclusions, WAC 246-853-730 Periodic review, and WAC 246-853-755 Tapering requirements, to modernize the language, add clarity, and align rules with the Washington Medical Commission (WMC).

The Board of Osteopathic Medicine and Surgery has adopted amendments to WAC 246-853-290, 246-853-300, 246-853-310, and 246-853-320 to update the rules regarding health profession monitoring programs. The adopted changes align existing rule language with the changes made in Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022). These changes align the rules with currently accepted language for substance use disorders and related monitoring programs.

The Board of Osteopathic Medicine and Surgery (board) conducted a review of all sections in chapter 246-853 WAC that have not been reviewed in the last five years and identified that WAC 246-853-045 and 246-853-210 contain outdated language. The board adopted amendments to update the term "practitioner" to "osteopathic physician" to be consistent with the entire chapter. The board has also identified that WAC 246-853-060 does not contain any rule language content and is repealing this section.

The Washington Medical Commission adopted amendments to WAC 246-918-895 and 246-919-945 to align rule language with currently accepted language.

The Board of Hearing and Speech adopted rules to reflect federal changes for over-the-counter (OTC) hearing aids. To align with changes in federal regulation, the board’s adopted amendment removes requirements in WAC 246-828-100 for medical clearance as a condition for sale of OTC hearing aids. The adopted changes to WAC 246-828-100 only remove requirements no longer permitted by federal rule and do not otherwise change licensure requirements.

The State Board of Health (SBOH) is considering amending WAC 246-290-315, State Action Levels (SALs) and State Minimum Contaminant Levels (MCLs), and WAC 246-290-71006, Public notice for contaminants with a SAL and other unregulated contaminants, to align with the federal Environmental Protection Agency’s (EPA) new federal standards for PFAS. The SBOH adopted an emergency rule and is now considering permanent rule amendments. 

The Washington State Department of Health (DOH) proposes to amend chapter 246-290 WAC, Group A Public Water Supplies, and chapter 246-390 WAC, Drinking Water and Laboratory Certification and Data Reporting, to align with recent changes to 40 CFR Part 141 regarding PFAS, and adopt the national primary drinking water regulations by reference.

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-480 to require additional reporting requirements to customers and the commission in advance of pharmaceutical firms permanently closing.

The Pharmacy Quality Assurance Commission (commission) is proposing to amend WAC 246-945-480 to require additional reporting requirements provided to customers and the commission in advance of permanent closures. The commission is proposing to add WAC 246-945-231 to consolidate the reporting requirement for pharmaceutical firms to report disciplinary action to the commission and add WAC 246-945-592 to establish reporting requirements for permanently closing manufacturers and wholesalers.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-480 and creating new sections in chapter 246-945 WAC to improve notifications and prescription transfer directions provided to patients when the facility closes permanently.

The Pharmacy Quality Assurance Commission adopted health equity continuing education requirements to meet the requirements of the Department of Health’s equity model rules in WAC 246-12-800 through 246-12-830. The adopted rules add one hour of health equity education every two years, coinciding with the license renewal cycles for both pharmacists and pharmacy technicians.

In 2020, the Pharmacy Quality Assurance Commission consolidated multiple chapters of rules into chapter 246-945 WAC that covers the practice of pharmacy. This adopted rule amends WAC 246-945-040(1) to incorporate Title 21 of the CFR by reference for the purpose of capturing any changes made to Title 21 after WAC 246-945-040 went into effect on July 1, 2020. Language was also added to the rule for the purpose of providing individuals directions for acquiring copies of the reference material listed for public inspection.

The Pharmacy Quality Assurance Commission is proposing to amend WAC 246-945-155 to grant additional renewals to pharmacy interns. Additionally, the commission proposes to amend WAC 246-945-156 to extend the duration of pharmacy intern temporary practice permits to 180 days which stems from compliance with Second Substitute House Bill (2SHB) 1009 (chapter 165, Laws of 2023).

The Pharmacy Quality Assurance Commission (commission) adopted amendments to WAC 246-945-155 and WAC 246-945-156 related to pharmacy intern registration requirements. The commission amended WAC 246-945-155 to grant additional renewals to pharmacy interns parties, and amended WAC 246-945-156 to extend the duration of pharmacy intern temporary practice permits to 180 days.

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-155, WAC 246-945-156, and adding a new section to chapter 246-945 WAC. These changes would grant renewal extensions to pharmacy interns and would extend temporary pharmacy intern practice permits for spouses of military personnel in accordance with Second Substitute House Bill 1009 (chapter 165, Laws of 2023).

The Pharmacy Quality Assurance Commission adopted amendments to WAC 246-945-345 and a created a new section, WAC 246-945-346, to establish the expectations of pharmacies related to noncontrolled and controlled substance prescription transfers upon patient request.

Withdrawal of CR-101 for considering adding kratom to the list of Schedule I substances. This CR-101, which was filed on August 22, 2024, and published in WSR 24-18-005, was withdrawn because the commission determined that kratom and its active alkaloids did not meet the necessary tests to place a substance in Schedule I, per RCW 69.50.201 and RCW 69.50.203.

Filed March 5, 2025, as WSR 25-06-091.

This policy statement establishes the commission-approved examinations for pharmacy technicians and pharmacists described in WAC 246-945-165 and 246-945-205.

Effective Date: December 12, 2024. Filed February 6, 2025 as WSR 25-05-009.

The Washington State Department of Health (DOH) adopted updates to outdated rule references.

Rescission of Policy Statement P004, Regulatory Standards Applicable to Remote Dispensing Sites. Filed February 8, 2024.

The pharmacy quality assurance commission (commission) is rescinding the policy statement Regulatory Standards Applicable to Remote Dispensing Sites, which was filed on July 2, 2020, and published as WSR 20-15-011.

The department of health is rescinding this policy statement because rulemaking was completed allowing a pharmacy to extend its pharmacy license to a remote dispensing site where technology is used to dispense medications used for the treatment of opioid use disorder or its symptoms. The CR-103P was filed under WSR 24-01-098 and went into effect on January 18, 2024.

Individuals requiring information on this rule should contact Joshua Munroe, rules and legislative consultant, phone 360-502-5058, email PharmacyRules@doh.wa.gov. 

The Pharmacy Quality Assurance Commission is considering amending WAC 246-945-001, 246-945-315, 246-945-317, 246-945-320, and potentially adding a new section in chapter 246-945 WAC to clarify the utilization of pharmacy ancillary personnel and technology within the pharmacy.

The Pharmacy Quality Assurance Commission proposed amendments to chapter 246-945 WAC to clarify when remodel inspections are required for remodeled pharmacies.

The Pharmacy Quality Assurance Commission adopted updates to references, made grammar corrections, and made other technical changes that do not affect implementation of the rule.

Citation of rules amended by this order: WACs 246-945-001, 246-945-011, 246-945-014, 246-945-018, 246-945-063, 246-945-156, 246-945-170, 246-945-173, 246-945-175, 246-945-200, 246-945-217, 246-945-230, 246-945-417, and 246-945-590.

The Pharmacy Quality Assurance Commission is considering amending existing rules and establishing a new section in chapter 246-945 WAC to implement a uniform enforcement tool for pharmaceutical firms. The rules will implement Engrossed Substitute Senate Bill (ESSB) 5271 (chapter 121, Laws of 2024).

The Pharmacy Quality Assurance Commission proposes adding a new section, WAC 246-945-007, to implement a uniform process for fining pharmacies in alignment with Engrossed Substitute Senate Bill 5271 (chapter 121, Laws of 2024). The rule outlines enforcement actions related to repeated violations and establishes fines scaled to severity and operation size.

The Washington State Department of Health (DOH) proposed amendments to WAC 246-945 to update references to federal standards to improve clarity and modernize regulatory requirements.

The Board of Physical Therapy (board) is proposing amendments to WAC 246-915-030, 246-915-040, 246-915-085, and 246-915-120 in order to comply with Section 8 of 2SHB 1724 (chapter 425, Laws of 2023), codified as RCW 18.130.077 and to make general and housekeeping updates to these sections. Additionally, the board is proposing amendments to WAC 246-915-040 to further expand upon the endorsement pathway required under 2SHB 1724 and amendments to WAC 246-915-120 to streamline the foreign educated applicant application process.

Continuance of public rules hearing. The Washington State Department of Health (DOH) and the Board of Physical Therapy (board) are proposing amendments to WAC 246-915-030, 246-915-040, 246-915-085, and 246-915-120 to reduce barriers to licensure. Additionally, the board is proposing amendments to WAC 246-915-040 to expand upon the endorsement pathway and amendments to WAC 246-915-120 to streamline the foreign educated applicant application process.

The Board of Physical Therapy and the Washington State Department of Health (DOH) adopted amendments to chapter 246-915 WAC, Physical Therapists and Physical Therapist Assistants, to clarify statutory requirements included in Second Substitute House Bill (2SHB) 1039 (chapter 198, Laws of 2023) for obtaining an intramuscular needling endorsement and to establish a fee to cover the cost of the endorsement. The adopted rules clarify and set standards to ensure that physical therapists who are seeking the endorsement are prepared with the skills and education needed to provide safe intramuscular needling services to the public.

The Board of Physical Therapy and Department of Health are proposing amendments to clarify statutory requirements for education and training and define the endorsement for intramuscular needling, and to amend fees and renewal cycle, to implement Second Substitute House Bill 1039, (chapter 198, Laws of 2023) which expands the scope of practice of physical therapists to perform intramuscular needling.

The Board of Physical Therapy (board) is updating existing rules to reference amendments to the most recent Physical Therapy Licensure Compact Commission (PTLC) rules. The board has adopted an updated effective date in WAC 246-915A-010 to match the date of the most recent PTLC rules to comply with RCW 18.74.500 Article IX(2).

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 for the Physical Therapy Compact per RCW 18.74.500 Article IX(2), updating the reference date to the most recent physical therapy licensure compact rules. This proposed rule will update the compact effective date to June 27, 2023. 

The Board of Physical Therapy has updated WAC 246-915A-010 to comply with RCW 18.74.500, Article IX (2), which mandates that the board adopt the most recent version of the compact commission rules to participate in the compact in the state of Washington. The adopted changes to WAC 246-915A-010 complies with the statute by incorporating by reference.

The Board of Physical Therapy is proposing to update the effective date in WAC 246-915A-010 to match the date of the most recent Physical Therapy Compact rules per RCW 18.74.500 Article IX(2). This proposed amendment will update the effective date in rule to June 17, 2024.

The Washington Medical Commission adopted amendments to WAC 246-918-076 and WAC 246-919-397 to align with the provisions of Second Substitute House Bill 1009, also known as the Military Spouse Employment Act, codified under RCW 18.340.020. These amendments streamline the license process for military spouses, ensuring consistency with state legislation and improving overall clarity and efficiency in the application process.

The Washington Medical Commission adopted amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants and supervising physicians. The commission also adopted amendments that clarify and update terms.

The Washington Medical Commission is proposing amendments to chapter 246-918 WAC to implement Engrossed Substitute House Bill (ESHB) 2041 (chapter 62, Laws of 2024) which aims to establish clear guidelines and requirements for the collaboration between physician assistants (PAs) and supervising physicians.

The Washington Medical Commission is proposing amendments to WAC 246-919-330 to remove two requirements that have become a barrier to licensure. The purpose of this proposal is to amend the rules to align them with current practices and remove barriers to licensure for qualified applicants entering the physician workforce.

The Department of Health is considering a chapter review to reorganize sections and amend rules regarding J-1 Physician Visa waivers. The department is exploring updates to help meet the greatest needs across Washington State. The department will also look for increased clarity in the organizational structure, application criteria, and requirements for letters of support.

The Podiatric Medical Board has adopted sections WAC 246-922-300 and WAC 246-922-310 to comply with RCW 43.70.163. The board adopted the Department of Health’s health equity model rules, WAC 246-12-800 through 246-12-830, for podiatric physicians and surgeons. The adopted rule adds two hours of health equity education, as required in the model rules, to be completed as part of the current continuing competency requirements every four years. In addition, the board also adopted amendments that correct some confusing rule language to clarify that a resident in an approved postgraduate residency training program is not required to participate in podiatric continuing medical education. 

The Podiatric Medical Board (board) adopted amendments to WAC 246-922-400, WAC 246-922-405, WAC 246-922-410, and WAC 246-922-415 to update language regarding health profession monitoring programs to align with changes made by Substitute Senate Bill (SSB) 5496 (chapter 43, Laws of 2022).

The Podiatric Medical Board is considering updates to reduce licensure barriers for podiatric physician and surgeons and amending reciprocity requirements in WAC 246-922-055 to comply with Second Substitute House Bill (2SHB) 1724 (chapter 425, Laws of 2023) codified at RCW 18.130.077.

The Secretary of Health will exercise enforcement discretion to permit pharmacists and pharmacy technicians to practice in Washington state without an active 
Washington state credential or certification under chapters 18.130, 18.64, or 18.64A RCW only for the purpose of assisting with prescription transfers due to the closures of Rite Aid and Bartell Drugs pharmacies in Washington.

Effective Date: June 1, 2025. Filed June 5, 2025, as WSR 25-13-006.

The Washington Medical Commission has adopted amendments to WAC 246-919-330 to eliminate the outdated requirement for consecutive years of training in no more than two programs. This change removes a barrier for qualified applicants to obtain licensure. This permanent rule will supersede the emergency rule filed on March 8, 2024, as WSR 24-07-019.

The Washington Medical Commission has adopted amendments to WAC 246-919-330 to eliminate the outdated requirement for consecutive years of training in no more than two programs. This change removes a barrier for qualified applicants to obtain licensure. This permanent rule will supersede the emergency rule filed on March 8, 2024, as WSR 24-07-019.

The Pharmacy Quality Assurance Commission is proposing amendments to WAC 246-945-015 and adding four new sections to chapter 246-945 WAC establishing prescription label accessibility standards to ensure meaningful access to prescription information for patients with visual impairments or print disabilities, and for limited English Proficient patients.

The Pharmacy Quality Assurance Commission adopted new accessible labeling rules to establish requirements for all dispensing facilities [i.e., pharmacies, nonresident pharmacies, healthcare entities (HCE), hospital pharmacy associated clinics (HPAC)] and dispensing practitioners (i.e., health professionals with prescriptive authority in the State of Washington). The adopted rule addresses establish that all practitioners and facilities in the state of Washington dispensing prescription medications shall provide information to the patient on the prescription container in a format that can be accurately comprehended by the patient and inform patients about the availability of accessibility services. The adopted rule creates four new sections WACs 246-945-026, 246-945-027, 246-945-028, and 246-945-029. WAC 246-945-015 is also amended to inform dispensing practitioners that they must comply with the new sections of rule.