This week is packed hearings on WSHA’s high-priority issues, including WSHA’s proactive bill improving the prior authorization process.
This week’s top bills with hearings in Olympia
SB 5395/HB 1566: Making improvements to transparency and accountability in the prior authorization determination process
WSHA strongly supports SB 5395/HB 1566, seeking to remedy issues that hospitals, providers and patients face in seeking care when using prior authorization process. Components include identifying who is performing the review and ensuring they are qualified to do the review, requiring a human to make final care determinations if there is a denial (not AI), standardizing use of AI tools and revising Office of the Insurance Commissioner (OIC) data collections.
WSHA also supports a standardized timeframe for carriers to release new prior authorization requirements or policy changes and requiring carrier reviewers for peer-to-peer appeals to have knowledge and experience regarding the service being reviewed. WSHA played a key role in crafting this legislation.
The Senate Committee on Health & Long Term Care will hold a public hearing on SB 5395 on Friday, Feb. 7. WSHA will testify in support. Members can sign in support SB 5395 here. (Andrew Busz)
SB 5579: Prohibiting health carriers, facilities, and providers from making any public statements of any potential or planned contract terminations unless it satisfies a legal obligation
WSHA opposes SB 5579, prohibiting providers and facilities from providing advance notice to patients of a contract termination. The bill would allow health carriers, hospitals and providers to provide disclosure to patients only when it is to satisfy a legal obligation or when the expiration or termination has already been disclosed publicly because of a legal obligation.
Hospitals and providers would be prohibited in most circumstances from communicating to patients about the termination, even those who need to make changes to care delivery due to changes in their insurance coverage.
Under the bill, the attorney general would be able to enforce violations under the consumer protection act as an unfair and deceptive trade act. WSHA opposes the bill, as it is one-sided in favor of carriers and would deprive most patients of needed information to plan for changes to coverage and care access.
The Senate Committee on Health & Long Term Care will hold a public hearing on SB 5579 Tuesday, Feb. 4. WSHA will testify opposed. (Andrew Busz)
SB 5254/HB 1496: Strengthening patients’ rights regarding their health care information
WSHA opposes SB 5254/HB 1496, which caps fees at $50 for providers to supply patient medical records. Patients and their personal representatives already get their own records for free or at a very reduced cost. However, plaintiff attorneys are currently charged for records. Attorneys often request complete patient records (which can be decades worth of documents) and use the records to identify potential lawsuits. Federal courts have twice held that attorneys are not entitled to medical records at patient rates.
The Senate Committee on Health & Long Term Care will hold a public hearing on SB 5254 Tuesday, Feb. 4. WSHA will testify in opposition. (Cara Helmer)
SB 5387/HB 1675: Concerning the corporate practice of medicine
WSHA opposes SB 5387/HB 1675, which restricts anyone without a license to practice medicine. The bill seeks to prevent interfering with, controlling or otherwise directing the professional judgments or clinical decisions of a licensed health care provider providing care to patients. This restriction applies to indirect as well as direct influence on patient care.
As drafted, this legislation would prevent non-licensed professionals from having influence over the time providers spend with patients, the timing of patient discharge, patient clinical status (including admission and discharge, determining referrals for further care, and diagnosis codes and clinical orders in medical records. There is also a section directed at non-hospital “professional service organizations” that seeks to give licensed providers greater power in practice decisions.
The Senate Committee on Health & Long Term Care will hold a public hearing on SB 5387 Friday, Feb. 7. WSHA will testify and offer amendments. (Cara Helmer)
SB 5561/HB 1686: Creating a health care entity registry
WSHA is looking to amend SB 5561/HB 1686, which would require a health care entity to report ownership and financial information each year that would be subject to search by members of the public and the state Department of Health. Hospitals that fail to comply would be subject to financial penalties.
WSHA appreciates the intent of this bill, which is to improve transparency and help lawmakers better understand the ownership relationship between health care entities. However, some provisions in the bill present undue administrative burdens and confidentiality concerns (especially with sensitive topics, such as gender-affirming care). Some elements of the legislation are also unclear in their intent.
The Senate Committee on Health & Long Term Care will hold a public hearing on SB 5561 Tuesday, Feb. 4. WSHA will testify to these concerns and offer amendments. (Katerina LaMarche)
HB 1567: Concerning licensure of health care administrators
WSHA opposes HB 1567, which would require hospital administrators to be licensed to perform their roles. Applicants would be required to take a test to obtain a license, pay pertinent fees and renew their licenses annually. WSHA opposes the bills, as the need for this regulation isn’t clear and it would make Washington the only state in the country with licensing requirements for hospital administrative roles. Additional fees would also unnecessarily increase health care spending.
The House Committee on Health Care & Wellness will hold a public hearing on HB 1567 Wednesday, Feb. 5. WSHA will testify in opposition. (Ashlen Strong)
Action opportunities
Each week, you’ll find WSHA’s calls to action here. You will have opportunities to sign-in on bills or contact legislators by email to tell them how legislation will impact your organization. This week, there are four bills to sign-in on:
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SB 5579: Prohibiting carriers, providers and facilities from providing advance notice to patients of an expected contract termination has a hearing in the Senate Committee on Health & Long-Term Care on Tuesday, Feb.4. WSHA has strong concerns with this legislation. Sign-in by 9:30 a.m. Tuesday, Feb. 4.
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SB 5254: Strengthening patients’ rights regarding their health care information which would cap fees for providers to supply patient medical records has a hearing in the Senate Committee on Health & Long-Term Care Tuesday, Feb. 4. WSHA will testify in opposition. Sign-in by 9:30 a.m. Tuesday, Feb. 4.
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HB 1566 and SB 5395 concerning reforms to the prior authorization process, will have hearings in the House Committee on Health Care & Wellness Wednesday, Feb. 5, and the Senate Committee on Health & Long-Term Care Friday, Feb. 7. WSHA strongly supports this legislation. Sign-in by 12:30 p.m. Wednesday, Feb. 5 for HB 1566. Sign-in by 7 a.m. Friday, Feb. 7 for SB 5395.
WSHA weighing in: Feb. 3-7
Monday, Feb. 3
- Senate Ways & Means
- SB 5079: Addressing the burden of unintentional overpayments on older adults and adults with disabilities served by the department of social and health services. (Zosia Stanley)
Tuesday, Feb. 4
- House Civil Rights & Judiciary
- HB 1507: Limiting health care nondisclosure agreements. (Cara Helmer)
- HB 1527: Concerning settlement demands or offers made prior to mandatory mediation of health care claims. (Cara Helmer)
- Senate Health & Long Term Care
- SB 5254: Strengthening patients’ rights regarding their health care information. (Cara Helmer)
- SB 5561: Creating a health care entity registry. (Katerina LaMarche)
- SB 5579: Prohibiting health carriers, facilities, and providers from making any public statements of any potential or planned contract terminations unless it satisfies a legal obligation. (Andrew Busz)
- Senate Labor & Commerce
- SB 5463: Concerning the duties of industrial insurance self-insured employers and third-party administrators. (Remy Kerr)
- Senate Law & Justice
- SB 5480: Protecting consumers by removing barriers created by medical debt. (Katerina LaMarche)
Wednesday, Feb. 5
- House Appropriations
- SHB 1162: Concerning workplace violence in health care settings. (Remy Kerr)
- House Health Care & Wellness
- HB 1566: Making improvements to transparency and accountability in the prior authorization determination process. (Andrew Busz)
- HB 1567: Concerning licensure of health care administrators. (Ashlen Strong/Mary Storace)
- Senate Human Services
- SB 5427: Extending the program to address complex cases of children in crisis. (Cara Helmer)
Thursday, Feb. 6
- Senate Health & Long Term Care
- SB 5568: Updating and modernizing the Washington state health plan. (Remy Kerr)
Friday, Feb. 7
- House Health Care & Wellness
- HB 1639: Requiring entities offering Medicare advantage coverage in Washington to provide certain disclosures to consumers. (Andrew Busz)
- Senate Health & Long Term
- SB 5324: Aligning the implementation of application programming interfaces for prior authorization with federal guidelines. (Andrew Busz)
- SB 5387: Concerning the corporate practice of medicine. (Cara Helmer)
- SB 5395: Making improvements to transparency and accountability in the prior authorization determination process. (Andrew Busz)
- SB 5557: Codifying emergency rules to protect the right of a pregnant person to access treatment for emergency medical conditions in hospital emergency departments. (Zosia Stanley)
Thank you for testifying!
Thank you to everyone who testified in support of WSHA’s legislative efforts last week:
- Isaac Ballou, Olympic Medical Center
- Chris Bredeson, EvergreenHealth
- Dr. Greg Carter, Providence St. Luke’s Rehabilitation Medical Center
- Elise Cutter, Island Health
- Matt Forge, Pullman Regional Hospital
- Brian Gibbons, Astria Health
- Deena Hannen, MultiCare Health System
- Ashley Thurow, Providence Health & Services
