Bill > HB1706

This bill revises prior authorization requirements for health plans, carriers, and managed care organizations in Washington state. It establishes specific time frames for processing prior authorization requests, with different standards for electronic and non-electronic submissions. For electronic standard requests, carriers must make decisions within three calendar days, and for electronic expedited requests, within one calendar day. Non-electronic requests have slightly longer timelines, with standard requests requiring five calendar days and expedited requests requiring two calendar days. The bill also mandates that prior authorization requirements be written in clear, understandable language and be based on evidence-based, peer-reviewed clinical review criteria that accommodate diverse population needs. Notably, the bill removes a previous requirement for organizations to build and maintain a specific prior authorization application programming interface (API), which was originally planned to be implemented by January 1, 2025. This change suggests a shift in how prior authorization technology will be approached, potentially allowing more flexibility in implementation while maintaining the goal of streamlining the prior authorization process.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=1706&Year=2025&Initiative=false