In response to provider and enrollee concerns, the Office of the Insurance Commissioner (OIC) announced it is considering rule-making to provide more specific requirements related to health plan prior authorizations. The rules would provide make the prior authorization process more predictable and transparent, and they would minimize the burden of the process on consumers. Both WSHA and the Washington State Medical Association had met with OIC staff encouraging the OIC to explore rule changes within the department’s authority to ensure prior authorization requirements and processes are transparent and reasonable.
The OIC will be accepting stakeholder comments through June 17. WSHA will provide draft comments prior to the June 17 deadline. Hospital staff who want to comment directly to the OIC may wish to use the WSHA draft comments to inform their own. Following the comment period, we expect OIC to share a stakeholder draft of specific rule changes for additional review and comment. (Andrew Busz)