OLYMPIA—A bill to improve patient access to care passed the Senate unanimously yesterday. Sponsored by Rep. Tarra Simmons, D-Bremerton, House Bill 1357 modernizes the prior authorization process. Before a healthcare provider can prescribe a drug, procedure, or test for a patient’s care, they must seek authorization from a patient’s health insurance company. This practice is known as ‘prior authorization,’ and health insurance companies often have different authorization standards and criteria for services based on the level of insurance or the healthcare provider.
“As a nurse for over a decade, I know that this practice harms patients by slowing access to the proper treatment,” said Simmons. “Our healthcare providers should be focused on getting their patients well, but instead, they have to spend time and resources obtaining prior authorization.”
HB 1357 updates the time frame for decisions by insurance companies, requires insurance companies to have electronic authorization options, and requires insurance companies to make their criteria for approving or denying treatment readily available. All of these steps will ensure that a patient is not denied needed treatment and speed up the timeframe in which they are able to access it.
The bill also requires health carriers to report to the Office of the Insurance Commissioner (OIC) the top ten prescription drugs for the previous year with the highest number of prior authorization requests, the highest percentage of approved prior authorization requests, and the highest percentage of prior authorization requests that were initially denied and then subsequently approved on appeal. This information will allow the Legislature and OIC to continue to improve patient access.
“This bill means healthcare providers will spending less time wrangling with insurance companies and more time caring for their patients. Our healthcare system should exist to get people well,” said Simmons. “This bill puts the patient’s needs first. Everyone agrees.”
HB 1357 passed the House unanimously on March 4th and the Senate unanimously on April 11th. Because it was amended in the Senate, it now returns to the House for concurrence.