Healthcare

HB 1706 requires health insurance carriers in Washington to implement digital systems (application programming interfaces) for prior authorization that align with federal standards. It sets strict time limits: carriers must decide on electronic prior authorization requests within 3 days (standard) or 1 day (expedited), and within 5 days (standard) or 2 days (expedited) for non-electronic requests. The bill mandates carriers to maintain evidence-based clinical review criteria that address disparities for underserved populations and adopt federal interoperability standards for electronic health data exchange. This directly affects insurance companies and healthcare providers who submit prior authorization requests, streamlining processes for both. The law takes effect July 27, 2025.

SB 5244 amends Washington state law to exempt WIC (Women, Infants, and Children) program staff from standard licensing requirements when performing specific blood tests. It allows WIC clinic staff to conduct hematological screening tests - using heel-stick, toe-stick, or finger-stick methods - without additional licensure, directly affecting WIC program employees statewide. The bill adds this exemption to existing provisions in RCW 18.360.090, limiting the tests to basic hematological evaluations only. This change streamlines WIC staff capabilities for routine screenings within their program, effective July 27, 2025.

SB 5128 requires Washington state to maintain Medicaid coverage for youth in juvenile detention facilities without interruption. It mandates that medical assistance benefits be suspended (not terminated) during detention, allows youth to apply for coverage while confined, and ensures full reinstatement of benefits immediately upon release. The bill creates a "suspense status" for applications during detention and requires coordination between state agencies, detention facilities, and healthcare providers to streamline coverage transitions. This directly affects youth in juvenile detention, Medicaid providers, and state agencies like the Department of Children, Youth, and Families. The law took effect July 27, 2025, after being signed by the Governor on April 4, 2025.

SB 5084 requires health insurance companies in Washington to annually report how much they spend on primary care services from the previous calendar year. This applies directly to all health insurance carriers operating in the state. The law mandates that these reports become public information and specifies that the state insurance commissioner will determine the format for reporting, considering existing definitions of primary care spending and related targets. The law takes effect on July 27, 2025.