Making improvements to transparency and accountability in the prior authorization determination process (Chapter 157, Laws of 2026)
Washington | SB 5395
Year Enacted
2026
Date Signed
Mar 23, 2026
Effective Date
Jun 11, 2026
Status
Enacted
Enacted
Categories
Payer Utilization Review
Key Requirements
Improves transparency and accountability in prior authorization determinations, including limits and disclosure requirements around the use of AI and automated tools in those determinations, and requires human clinical review for adverse determinations.
Regulated Parties
Health carriers and their utilization review/prior authorization vendors
Enforcement
Washington Office of the Insurance Commissioner oversight
Sources
Notes
Official bill summary shows 'Chapter 157, 2026 Laws', Governor signed Mar 23, effective 6/11/2026.
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