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.

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

LEGISLATION: The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design. The database also includes pharmaceutical legislation beginning in the 2017-2018 legislative session. *Note: Current legislative session bill updates are ongoing. Check back weekly for updates.

LITIGATION: The Source tracks major litigation and antitrust enforcement action by federal entities (FTC or DOJ), state attorney generals, and private parties in the main provider and insurer markets, particularly legal challenges of healthcare consolidation and anticompetitive contract provisions. Additionally, the database contains major pharmaceutical cases including legislation challenges and significant appellate cases.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, status, and/or key issue category. *Multiple filter/selections enabled. Click here for User Guide.

Recent Legislation

Filter by Key Issue, Year, or Status

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: In Process
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 1185 – Washington
Introduced: 2019 Status: In Process
ASSURING ACCESS TO HEALTH CARE SERVICES FOR MEDICAID BENEFICIARIES BY APPLYING THE MEDICARE RATE FLOOR TO HEALTH CARE SERVICES FURNISHED UNDER MEDICAID BY HEALTH CARE PROVIDERS. Medicaid payment for health care services furnished by a licensed …

Next | See all Legislation Records

Enacted Laws

Filter by Key Issue

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 1239 – Washington
Introduced: 2019 Status: Enacted
Protecting the Confidentiality of Health Care Quality and Peer Review Discussions to Support Effective Patient Safety – Allows public hospitals to conduct executive sessions regarding hospital privileges and quality improvement programs.

HB 1394 (see companion bill SB 5431) – Washington
Introduced: 2019 Status: Enacted
Concerning community facilities needed to ensure a continuum of care for behavioral health patients. Exempting psychiatric beds from Certificate of Need. Establishes intensive behavioral health treatment facilities and provides for the licensing and certification of …

Next | See all Legislation Records

Key Litigation

Filter by Key Issue

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 …

See all Litigation Records

Additional Resources

LEGISLATIVE CALENDAR

Washington’s latest legislative session ran from 1/14/2019 – 4/23/2019. Bills from 2019 will carry over to 2020 as part of the 2019-2020 legislative term.

2019 – 2021 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.