Overview
Washington is a leading state in terms of healthcare reform legislative efforts. In the 2019 session, the Legislature passed legislation to provide a public option health insurance plan (HB 5526) to brings its residents a step closer to universal healthcare. The state also enacted bills to tackle surprise and balance billing (HB 1065) and promote transparency in network adequacy (HB 1099) and prescription drugs pricing (HB 1224). In healthcare markets, the Legislature enacted HB 1607 to give the state attorney general additional merger review authority of healthcare entities. Additionally, HB 1870 would protect against pre-existing conditions and provide essential health benefits in the case of repeal of the Affordable Care Act.
In 2018, the state introduced a number of price transparency and cost control bills aimed at tackling prescription drug costs. Notably, the legislature passed a bill to promote telemedicine in the state. SB 6399 would establish a telemedicine payment parity pilot program to provide parity in reimbursement for certain health care services and requires certain health care professionals to complete telemedicine training.
In the 2017 legislative term, Washington actively built upon its legislation promoting price transparency by continuing to pass legislation related to the creation of the state’s APCD. The state legislature passed SB 5084 in 2015, which established an APCD in the state. The Washington All Payer Health Care Claims Database (WA-APCD) is administered by the state’s Office of Financial Management through its lead organization, the Center for Health Systems Effectiveness (CHSE) at Oregon Health & Science University (OHSU). In July 2018, the state launched the new public face of the WA-APCD program, named Washington HealthCareCompare. The site will aggregate health care claims information of over 4 million Washington residents to present informative cost comparisons for consumer, as well as statistical reports and data access for health care industry insiders.
State Action
2020 Legislative Session: 1/13/2020 - 3/12/2020 (2019-2021 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 1065 (see companion bill SB 5031) – Washington
Introduced: 2019 Status: Enacted
PROTECTING CONSUMERS FROM CHARGES FOR OUT-OF-NETWORK HEALTH CARE SERVICES. The carrier must treat any cost-sharing amounts paid by the enrollee for an out-of-network provider or facility’s services in the same manner as cost-sharing for health care …
HB 1085 (see companion bill SB 5469) – Washington
Introduced: 2019 Status: In Process
Concerning premium reduction for medicare-eligible retiree participants in the public employees’ benefits board program.
HB 1099 – Washington
Introduced: 2019 Status: Enacted
Providing Notice About Network Adequacy to Consumers – Requires the Insurance Commissioner’s rules to be amended to require each health carrier to include in its electronic provider directory a notation of any mental health or …
HB 1104 – Washington
Introduced: 2019 Status: Inactive / Dead
REQUIRING THE SUBMISSION OF A WAIVER TO THE FEDERAL GOVERNMENT TO CREATE THE WASHINGTON HEALTH SECURITY TRUST. The people of the state of Washington declare their intention to create a single health financing entity called the …
HB 1109 (see companion bill SB 5153) – Washington
Introduced: 2019 Status: Enacted
Making 2019-2021 biennium operating appropriations. (15) $100,000 of the general fund—state appropriation for fiscal year 2019 is provided solely for the Washington state institute for public policy to conduct a study of single payer and …
HB 1065 (see companion bill SB 5031) – Washington
Introduced: 2019 Status: Enacted
PROTECTING CONSUMERS FROM CHARGES FOR OUT-OF-NETWORK HEALTH CARE SERVICES. The carrier must treat any cost-sharing amounts paid by the enrollee for an out-of-network provider or facility’s services in the same manner as cost-sharing for health care …
HB 1224 – Washington
Introduced: 2019 Status: Enacted
CONCERNING PRESCRIPTION DRUG COST TRANSPARENCY. Requires health carriers, pharmacy benefit managers, pharmacy services administrative organizations, and drug manufacturers to report certain prescription drug pricing data to the Health Care Authority (HCA). Requires manufacturers to provide advance …
HB 1432 (see companion bill SB 5648) – Washington
Introduced: 2019 Status: Enacted
CONCERNING HOSPITAL PRIVILEGES FOR ADVANCED REGISTERED NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS. In lieu of the requirements of subsections (1) and (2) of this section, when granting or renewing privileges or association of any physician, physician assistant, …
HB 1607 – Washington
Introduced: 2019 Status: Enacted
CONCERNING NOTICE OF MATERIAL CHANGES TO THE OPERATIONS OR GOVERNANCE STRUCTURE OF PARTICIPANTS IN THE HEALTH CARE MARKETPLACE. Not less than sixty days prior to the effective date of any transaction that results in a material …
HB 1777 – Washington
Introduced: 2019 Status: Enacted
EXEMPTING CERTAIN EXISTING AMBULATORY SURGICAL FACILITIES FROM CERTIFICATE OF NEED.
Federal Trade Commission and State of Idaho v. St. Luke’s Health System, Ltd and Saltzer Medical Group, P.A. – California, Connecticut, Delaware, Idaho, Illinois, Iowa, Kentucky, Maine, Maryland, Mississippi, Montana, Nevada, New Mexico, Oregon, Pennsylvania, Tennessee, Washington
District Court: District of Idaho Status: Decided
In March 2013, the FTC and the Idaho Attorney General filed a joint complaint challenging the merger betweenSt. Luke’s Health System, Idaho’s largest health system, …
State of Washington v. Franciscan Health System, et al. – Washington
District Court: W.D. Washington Status: Decided
In August 2017, the Washington State Attorney General filed suit to thwart and unwind Franciscan Health System’s consummated 2016 acquisition of two physician practice groups, …
In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In re: EPIPEN (Epinephrine Injection, USP) Marketing, Sales Practices, and Antitrust Litigtion – Illinois, Kansas, New Jersey, Washington
District Court: District of Kansas Status: Pending
The plaintiffs in the case allege Mylan N.V. created and exploited an EpiPen monopoly by providing aggressive rebates and incentives to pharmacy benefit managers to …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Washington enacts budgets on a two-year cycle, beginning July 1 of each odd-numbered year. Washington’s new Biennial Budget will take effect on July 1, 2019 and is valid through June 30, 2021. To view Washington’s enacted 2019-2021 Budget, click here.
REGULATION & ENFORCEMENT
- Washington was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.
KEY RESOURCES
News & Articles
