SB 5324 Washington Senate · 2025-2026 Regular Session

Aligning the implementation of application programming interfaces for prior authorization with federal guidelines.

SB 5324 requires Washington health insurance carriers to implement digital connections (APIs) for prior authorization processes by 2025, aligning with federal standards. It sets strict time limits: 3 days for standard electronic requests and 1 day for expedited requests, with clear rules for handling missing information. Carriers must use evidence-based clinical criteria that consider health equity for underserved groups and make prior authorization rules accessible in plain language. This directly affects health insurers offering plans renewed after 2024, mandating faster, more transparent digital workflows for providers.

Issues: ✓ Healthcare ✓ Technology

Bill status in committee 1 of 4 stages cleared

Introduction

Jan 2026

Committee Review

Floor Vote

Governor

Introduced Jan 12, 2026 Last action Jan 12, 2026

Maddy AI version diff · 1 comparison

What changed between versions

Bill → Substitute Bill · 4 edits

MODERATE

This bill was renumbered and amended to update the implementation timeline for prior authorization application programming interfaces (APIs). The primary change shifts the mandatory enforcement start date from January 1, 2026, to January 1, 2027, and removes the condition that enforcement depends on federal rules being finalized by a specific date. This ensures the new interoperability requirements take effect regardless of delays or suspensions in federal rulemaking.

Scope change

The bill's applicability remains the same, covering carriers, health plans, and managed care organizations, but the operational requirements now apply with a later effective date and without waiting for federal finalization.

TIMELINE

The enforcement start date for prior authorization API requirements was changed from January 1, 2026, to January 1, 2027.

Updated the reference date for federal rule delays from September 13, 2023, to February 8, 2024.

ENFORCEMENT

Removed the clause that delayed enforcement until federal rules were finalized, ensuring the state requirements apply even if federal rules are revoked, delayed, or suspended.

TECHNICAL

Updated bill identifiers from Senate Bill 5324 to Substitute Senate Bill 5324 and changed the reading date to reflect the legislative session progress.

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Full legislative history

Actions timeline

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Key actions

Committee

Jan 12, 2026

Introduced

By resolution, reintroduced and retained in present status.

upper

Feb 11, 2025

Upper · Passed

Executive action taken in the Senate Committee on Health & Long-Term Care at 10:30 AM.

upper

Feb 7, 2025

Upper · Passed

Public hearing in the Senate Committee on Health & Long-Term Care at 8:00 AM.

upper

1 primary · 3 co-sponsors