WSHA recently sent the Office of the Insurance Commissioner (OIC) a comment letter and recommendations in response to the OIC’s request for comments related to health plan prior authorizations. The OIC is considering rulemaking to streamline the prior authorization process and make it easier for consumers and providers to get prior authorizations. Both WSHA and the Washington State Medical Association have encouraged 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. We encourage hospitals that want to comment directly to the OIC to refer to the WSHA draft comments and add their own specific comments. In our letter, WSHA focused on specific areas of concern that were identified by its prior authorization work group and are considered within the OIC’s rulemaking authority. The letter included recommendations regarding transparency, timeliness of response, handling of extenuating circumstances, and evaluation of new prior authorization requirements. The OIC is interested in obtaining a range of information from stakeholders, including identification of best practices, failed attempts at streamlining, and current deficiencies in current regulations regarding prior authorization.
Following the comment period, we expect the OIC to share a stakeholder draft of specific rule changes for additional review and comment.
To view WSHA’s comment letter click here.
To view the OIC announcement and email address to submit stakeholder comments, click here.
(Andrew Busz, firstname.lastname@example.org)