HB 1357 – Washington

Status: Enacted
Year Introduced: 2023
Link: https://app.leg.wa.gov/billsummary?BillNumber=1357&Year=2023&Initiative=false

Modernizing the prior authorization process. Establishes requirements for the prior authorization process for private health insurance, Public Employee Benefit Board and School Employee Benefit Board health programs, and Medicaid programs related to time frames for decisions, qualifications for reviewers, electronic authorization options, and communication requirements. Directs the Office of the Insurance Commissioner to adopt rules to prohibit carriers from requiring prior authorization for billing codes with an approval rate over 95 percent. Eliminates the requirement that the affected enrollee must have suffered substantial harm and sought independent review of the health care treatment decision in order to bring a cause of action against a health carrier for failure to meet the standard of care.


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