E2SHB 1357: Modernizing the prior authorization process.

What this bill does

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.

From the Washington State Legislature's nonpartisan staff bill analysis. Read the full analysis ↗

Floor votes

• House: 3rd Reading & Final Passage · March 4, 2023
  96 yea · 0 nay · 2 not voting
• House: Final Passage as Amended by the Senate · April 18, 2023
  97 yea · 0 nay · 1 not voting
• Senate: 3rd Reading & Final Passage as Amended by the Senate · April 11, 2023
  49 yea · 0 nay

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