Insurance Commissioner to Begin Rulemaking on Prior Authorizations

April 19, 2016

Many of our members have expressed frustration with the increasing burden of expanding health plan requirements on prior authorizations. WSHA and the Washington State Medical Association have been in discussions with the health plans directly as well as with the Office of the Insurance Commissioner (OIC).

OIC recently announced its intent to begin rulemaking to provide more specific requirements relating to health plan prior authorizations. The rules seek to provide greater transparency and predictability for the prior authorization process and minimize the burden of the process on consumers.  Both WSHA and the Washington State Medical Association have met with OIC staff encouraging the OIC to explore rule changes within the Department’s authority to ensure prior authorization processes are transparent and reasonable. We will be very involved in the rulemaking process as it unfolds and continue to communicate with you as more information is known. (Andrew Busz, andrewb@wsha.org).

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