This bill aims to modernize the prior authorization process for health care services and prescription drugs in Washington. Starting from January 1, 2024, carriers offering a health plan, including to public employees and retirees, must follow certain standards related to prior authorization. Determinations and notifications about authorization requests done electronically must occur within three calendar days if standard and one calendar day if expedited. For non-electronic requests, decisions should be made within five calendar days and two calendar days respectively. Prior authorization requirements must be clearly written and made available in electronic format upon request, with the criteria based on peer-reviewed, evidence-based research that reflects the needs of diverse populations. Health plans should build and maintain an application programming interface facilitating the process of determining prior authorization for services beginning from January 1, 2025.

AN ACT Relating to facility fees charged by certain affiliated health care providers

AN ACT Relating to provider contract compensation; adding a new section to chapter 48.43 RCW; and creating new sections.

AN ACT Relating to preserving coverage of preventive services without cost sharing

Developing the Washington health trust.

Concerning material changes to the operations and governance structure of participants in the health care marketplace.

Concerning material changes to the operations and governance structure of participants in the health care marketplace.