Revising the prior authorization process (R 2023-02)

E2SHB 1357 (Chap. 382, Laws of 2023) alters prior authorization requirements for commercial health plans under RCW 48.43. The new guidelines change prior authorization decision timelines, electronic and non-electronic submission standards, and communication and reporting requirements. OIC rulemaking is necessary to effectuate the bill’s language related to prior authorization timelines and processes and to address any inconsistencies between the bill and current rule language. The rules will facilitate implementation of the new law by ensuring that all affected entities understand their rights and obligations.