Washington SB5395 enhances transparency and accountability in the prior authorization process for health care services and prescription drugs.

Washington SB5395 mandates that health insurance carriers, health plans, and managed care organizations must ensure transparency and accountability in the prior authorization process. It requires these entities to establish and maintain an interoperable electronic process or application programming interface to automate prior authorization requests and determinations. The bill also sets specific time frames for making decisions on standard and expedited prior authorization requests, both electronic and nonelectronic.

Washington SB5395 enhances transparency and accountability in the prior authorization process for health care services and prescription drugs.

Washington SB5395 mandates that health insurance carriers, health plans, and managed care organizations must ensure transparency and accountability in the prior authorization process. It requires these entities to establish and maintain an interoperable electronic process or application programming interface to automate prior authorization requests and determinations. The bill also sets specific time frames for making decisions on standard and expedited prior authorization requests, both electronic and nonelectronic.