Bill > SB5683

This bill aims to increase transparency around health insurance claims payment by requiring health carriers, managed care organizations, and public employee health plans to report detailed metrics about their claims processing to state authorities. Starting in January 2027, these organizations will need to submit annual reports detailing information such as the total number of claims submitted, the number of "clean claims" (claims without defects or missing documentation), the average and range of days to process and pay claims, and the percentage of claims paid within 30 days. By July 2027, the Office of the Insurance Commissioner and the Health Care Authority will be required to compile these reports, publish them on public websites, and submit them to legislative committees. The reports will include detailed information from each carrier, summaries of claims processing, a compilation of complaints received about claims payment, and an analysis of trends in claims processing timeliness. The legislature recognizes that slow or delayed payments can negatively impact health care providers' financial stability and ultimately affect patient care, and this bill seeks to create more accountability and transparency in the claims payment process.

Budget and Finance, Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5683&Year=2025&Initiative=false