Sund v. Regence BlueShield, No. 13-2-03122-1 SEA (King County Superior Court)
Feb 26, 2014OUTCOME: Settlement requires State of Washington to pay the cost of our clients' SCS and implement certain measures to bring the HTCC into compliance with the Washington Constitution.
Few people have ever heard of Washington's Health Technology Clinical Committee, or HTCC. Here's a quick overview: It's a committee of unelected individuals given the power to evaluate health technolog ... ies and determine whether participating Washington state agencies may lawfully cover them. HTCC decisions carry the force of law. The decisions affect the health care of hundreds of thousands, if not more than a million, Washingtonians. Despite having this breathtaking power over matters of health—matters of life and death—the law establishing the HTCC rendered the committee totally unaccountable. Avenues for reviewing HTCC decisions were explicitly foreclosed. When the HTCC disfavored a technology, regardless of whether its decision was right or wrong, it meant that courts and participating agencies were prohibited from considering whether the technology was “medically necessary, or proper and necessary treatment” in the case of the individual patient. RCW 70.14.120(3). The dangers of the HTCC’s unchecked power were thrown into sharp relief in the case of our clients, a former state judge and his wife. Both had insurance through the state-funded Uniform Medical Plan, which is a health plan for state employees. The plan denied a request for spinal cord stimulation (SCS) based on an HTCC edict prohibiting coverage for SCS in cases of chronic neuropathic pain—even though doctors believed SCS was medically necessary to treat the judge’s crippling pain. Represented by the State Attorney General, the UMP argued that the HTCC law stripped courts of the power of judicial review over HTCC decisions. The idea that a government decision can prohibit someone from receiving a life-saving treatment without any way to appeal the decision should send shivers up the spines of people who care about good government and accountability. Last October, our legal team at Keller Rohrback obtained a ruling from King County Superior Court Judge Beth Andrus that RCW 70.14.120(3) of the HTCC law was an unconstitutional delegation of lawmaking power because there were insufficient procedural safeguards to control arbitrary or abusive agency action. That ruling precipitated a settlement. Under the settlement, the State of Washington waived its right to appeal the King County Superior Court's decision that the law is unconstitutional. The State must pay the cost of our clients' SCS and implement certain measures to bring the HTCC into compliance with the Washington Constitution. I'm extremely proud of the work that we did on this important case. And I'm honored that our clients trusted us to bring this fight on their behalves—a fight that some thought they could never win.
