Washington HB1566 aims to enhance transparency and accountability in the prior authorization process for health care coverage decisions.

Washington HB1566 mandates that health carriers and managed care organizations cannot retrospectively deny coverage for emergency and nonemergency care that had prior authorization under the plan's written policies at the time the care was rendered. It requires health plans to notify providers or facilities of the results of prior authorization decisions within specific timeframes. The bill also mandates the use of artificial intelligence and other software tools in prior authorization processes, ensuring these tools are not the sole means used to deny, delay, or modify health care services.

Washington HB1566 aims to enhance transparency and accountability in the prior authorization process for health care coverage decisions.

Washington HB1566 mandates that health carriers and managed care organizations cannot retrospectively deny coverage for emergency and nonemergency care that had prior authorization under the plan's written policies at the time the care was rendered. It requires health plans to notify providers or facilities of the results of prior authorization decisions within specific timeframes. The bill also mandates the use of artificial intelligence and other software tools in prior authorization processes, ensuring these tools are not the sole means used to deny, delay, or modify health care services.