WA HB1706

Health carriers, public employee health plans, and Medicaid managed care organizations must establish prior authorization APIs consistent with federal CMS rules, with enforcement beginning January 1, 2027

Electronic standard prior authorization requests require decisions within 3 calendar days; expedited requests require decisions within 1 calendar day

Nonelectronic standard requests require decisions within 5 calendar days; nonelectronic expedited requests require decisions within 2 calendar days

Carriers must maintain interoperable electronic systems for prescription drug prior authorization beginning January 1, 2027, including information on covered alternative drugs

Prior authorization denials or authorizations for less intensive services than requested must be identified as adverse benefit determinations subject to grievance and appeal processes