For Insurers

Independent review organization (IRO) RCWs and WACs

Learn more about the RCWs and WACs that relate to assignments of independent review organizations (IROs).


Each RCW link will take you to the Washington State Legislature's website (

RCW 48.005 Definitions

RCW 48.43.530 Requirement for carriers to have comprehensive grievance and appeal processes (carrier's duties, procedures, appeals and rules)

RCW 48.43.535 Independent review of health care disputes (system for using certified independent review organizations and rules)

RCW 48.43.537 Health care disputes (certifying independent review organizations, application, restrictions, maximum fee schedule for conducting reviews and rules)


Each WAC link will take you to the Washington State Legislature's website (

WAC 284-43A-001 Purpose and scope

WAC 284-43A-010 Definitions

WAC 284-43A-020 General requirements for certification

WAC 284-43A-030 Application for certification as an IRO

WAC 284-43A-040 Administrative processes and capabilities of IROs

WAC 284-43A-050 Conflict of interest

WAC 284-43A-060 Expert reviewers

WAC 284-43A-070 Independent review process

WAC 284-43A-080 Criteria and considerations for independent review determinations

WAC 284-43A-090 Additional requirements for experimental or investigational treatment reviews

WAC 284-43A-100 Ongoing requirements for IROs

WAC 284-43A-110 Powers of the commissioner

WAC 284-43A-120 Grounds for action against an applicant or a certified IRO

WAC 284-43A-130 Maximum fee schedule

WAC 284-43A-140 External review of adverse benefit determinations

WAC 284-43A-150 Independent review of adverse determinations