HB1357 - Mostly GOOD BILL

Bill Title: Modernizing the prior authorization process

Companion Bill: none

Bill Summary:

  • AN ACT Relating to modernizing the prior authorization process; 1 amending RCW 48.43.0161; adding new sections to chapter 48.43 RCW; 2 adding a new section to chapter 41.05 RCW; and adding a new section 3 to chapter 74.09 RCW.

What the Bill says:

  • It sets structure to the prior approval authorizations for healthcare / insurance carriers. It covers critical care requirements: “Expedited prior authorization request” means a request by a provider or facility for approval of a health care service where the passage of time could seriously jeopardize the life or health of the enrollee, seriously jeopardize the enrollee’s ability to regain  maximum function, or, in the opinion of a provider or facility with  knowledge of the enrollee’s medical condition, would subject the  enrollee to severe pain that cannot be adequately managed without the  health care service that is the subject of the request.

What the bill means:

  • It mandates that website portals be created and providers be given access to speed up the prior authorization process. It mostly does a good job of addressing the issues surrounding slow downs in getting health treatments. I would call this an excellent bill if it added one thing: Any long term chronic diagnosed treatment plan should not need more than one prior approval for the provider and the meds and the testing per year. That would remove so many struggles with regards to someone’s cancer treatments. I hope someone in Olympia will offer that amendment and get it passed!

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