Bill > SB5588

This bill addresses the relationships between health insurance carriers (health plans) and healthcare providers by establishing new rules for network adequacy, contract negotiations, and provider participation. The bill first modifies existing law to require the insurance commissioner to review provider networks to ensure they have sufficient specialists across various medical services, including emergency medicine, radiology, and behavioral health services. It introduces an "alternate access delivery request" process that allows carriers to seek approval for networks with limited provider options, but requires them to demonstrate good faith efforts to contract with providers and ensure patients are not financially penalized. The bill also adds a new section mandating that carriers provide healthcare providers a meaningful opportunity to negotiate contract terms in good faith, prohibiting practices like requiring providers to accept multiple plan contracts (all-or-nothing clauses) or mandating discounted rates across different contracts. Additionally, carriers must provide contract updates directly to providers and cannot require access to secure websites for critical information. The bill expands the definition of health carriers to include dental-only plans and applies these provisions to health care benefit managers, with an implementation date of January 1, 2027. The insurance commissioner is authorized to adopt rules to implement these new requirements, which aim to create more transparent and equitable provider-carrier relationships.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5588&Year=2025&Initiative=false