WAS LEG Insurance Authorization APIs

Published on: May 21, 2025

On Apr. 7, WAS LEG enacted bill on health care prior authorization API.

  • WAS LEG enacted bill HB 1706 on aligning implementation of application programming interfaces (APIs) for health care services prior authorization with federal guidelines.
  • Amended WAS INS 48.43.830, WAS INS 41.05.845, and WAS INS 74.09.840.
  • Document dated Apr. 7, 2025, was received on May 16, 2025, due to a fixed feed.
  • Legislative Provisions
  • Technical requirements for prior authorization APIs are replaced with requirement that a carrier, health plan, managed care organization APIs that align with CMS final rules.
  • Requirements for APIs that automate process for in-network providers to check prior authorization is required for covered prescription are applied to electronic processes.
  • State requirements regarding prior authorization APIs are enforceable Jan. 1, 2027.
  • Legislative History
  • On Jan. 29, 2025, bill introduced into House; on Mar. 4, 2025, bill passed House.
  • On Mar. 6, 2025, bill introduced into Senate; on Mar. 26, 2025, bill passed Senate.
  • On Apr. 2, 2025, delivered to governor; on Apr. 7, 2025, signed by governor, Ch. 25.
  • Effectiveness
  • Act is effective as of Jul. 27, 2025.
Regulators
WAS LEG
Entity Types
Ins
Reference
Ch. 25, Bill HB1706, 4/7/2025; Citation: *WAS INS* 48.43.830, 41.05.845, 74.09.840;
Functions
Claims/Accelerated Benefits; Compliance; Operations; Technology
Countries
United States of America
Category
State
N/A
Products
Insurance; Insurance-Health
Rule Type
Final
Regions
Am
Rule Date
Apr 7, 2025
Effective Date
Jul 27, 2025
Rule ID
255135
Linked to
N/A
Reg. Last Update
Apr 7, 2025
Report Section
US Insurance