2023 Legislative Session Overview

May 5, 2023
Prepared for WA-ACEP by Sean Graham, WA-ACEP Lobbysit 

The 105-day 2023 legislative session adjourned “sine die” on April 23. Before leaving Olympia legislators adopted a two-year state operating budget that takes effect July 1. Totaling nearly $70 billion, the spending plan makes substantial investments in health care workforce, behavioral health, abortion access, and public health. Between the budget and nearly 500 policy bills that were passed this year, there were numerous wins for patients and the physician community.

Spanning thousands of appropriations over more than 1,400 pages, the operating budget funds most of the functions that we think of as state government – education, social services, natural resources and health care, among many others. The 2023-25 budget increases state spending by around $5 billion, with major areas of new investments including climate change, housing and homelessness, and special education. The budget also funds more than $2 billion in pay increases for state workers collectively bargained by the Governor and labor unions.

Among the top budget priorities of the physician community in the 2023 session were increasing Medicaid rates and bolstering health care workforce. To the latter, the budget increases investments in physician residencies, health professional loan repayment and nurse education and training. And while the final budget does make provision for Medicaid rate increases, it only partially funds the physician community ask of across-the-board increases to at least the rates paid by Medicare. Continued advocacy will be needed to ensure the state is fully funding the Medicaid program and supporting access to care for patients.

Highlights of the Final Budget

  • Medicaid reimbursement: $32 million for rate increases for Medicaid “professional services” delivered by physicians, physician assistants, and ARNPs, effective July 1, 2024. An additional $3.1 million is dedicated to primary care rate increases and $6.2 million for certain behavioral health provider rates.
  • Physician residencies: $18 million for physician residencies through the state’s Family Medicine Residency Network. An additional $5 million is appropriated for psychiatric residencies.
  • Health professional loan repayment: The budget provides increased funding for the state’s Health Professional Loan Repayment Program as well as the loan program dedicated to behavioral health professionals.
  • Reproductive health care services: $15.5 million to maintain access to abortion, including funding for patient outreach, workforce retention and security investments.
  • Foundational Public Health Services: More than $300 million for continued support of the state’s public health system.
  • Opioid epidemic: Among numerous appropriations seeking to help address the opioid epidemic, $1.8 million for opioid education, including an expansion of the Better Prescribing, Better Treatment initiative of WSMA and WSHA.

No significant tax increases were included in the final budget. During the 2023 session there was consideration of the establishment of a “wealth tax,” replacing the state’s business & occupations tax with a “margin” tax, and increasing property taxes to fund housing. None of those efforts made it across the finish line.

Another bill that failed to make it through the process was Senate Bill 5536, which sought to address the state Supreme Court’s 2021 “Blake” decision that effectively decriminalized personal drug possession. In the 2021 session the Legislature passed a temporary fix setting possession as a misdemeanor. That law expires June 30 so in the absence of further legislative action, personal drug possession would be decriminalized at the state level on July 1, leaving municipalities the option to adopt local-level drug possession regulations.

SB 5536 was negotiated extensively through session in an effort to find an approach that balanced public health and public safety, but on the final day of session a compromise bill was voted down by the House of Representatives. Gov. Inslee has announced a special session will commence on May 16 to complete work on SB 5536.

Legislative Highlights of the 2023 Session

Abortion access

  • House Bill 1340 / Medical license protections: Clarifies that reproductive health and gender affirming care services delivered consistent with Washington state standards of care (even in a state where such services are prohibited) do not constitute unprofessional conduct.
  • House Bill 1469 / Shield act: Establishes liability protections for patients and health care professionals based on the receipt or delivery of abortion services and gender affirming care.
  • Senate Bill 5242 / Abortion cost sharing: Prohibits cost sharing (e.g., copays, deductibles) on abortion services.

Gun violence

  • House Bill 1240 / Assault weapons: Generally prohibits the manufacture and sale of semi-automatic “assault weapons,” including firearms such as the AR-15 and AK-47.
  • House Bill 1143 / Firearm purchase: Requires individuals to have recently completed a firearm safety training program and undergo a background check and 10-day waiting period to be eligible to purchase firearms.
  • Senate Bill 5078 / Gun industry liability: Establishes a right of action against the firearm industry in circumstances where violence results from its conduct such as advertising targeted at minors and promoting the illegal conversion of firearms.

Prior authorization

  • House Bill 1357 / Prior authorization: Modernizes and standardizes prior authorization by shortening turnaround times for determinations and mandating insurance carriers implement electronic prior authorization processes that integrate into providers’ EMR.

Scope of practice was another priority issue area, with numerous concerning scope bills defeated. The exception was Senate Bill 5389, which expands optometrists’ scope to include surgical procedures, injections, and increased prescriptive authority. The bill is currently pending the consideration of Gov. Inslee – numerous physician organizations have petitioned that the bill be vetoed.

Agencey and Funding Description
Department of Health
Cardiac Stroke Response Program: Funding is provided for continued implementation of Chapter 58, Laws of 2022 (SSB 5821), which requires DOH to evaluate the state’s current system for cardiac and stroke emergencies and to provide recommendations to the Legislature regarding potential improvements. (General Fund-State): Funding is provided for continued implementation of Chapter 58, Laws of 2022 (SSB 5821), which requires DOH to evaluate the state’s current system for cardiac and stroke emergencies and to provide recommendations to the Legislature regarding potential improvements. (General Fund-State) $85,000
Secure Reproductive Health Services: The department will reimburse abortion clinics for reproductive care for people who are unable to afford these services and for reimbursement of travel expenses, including, but not limited to, childcare, meals and lodging. Additionally, the department will provide grant funding to public four-year institutions of higher education that offer advanced degrees in nursing, medicine, or pharmacy to develop and offer abortion care training for students and licensed providers. (General Fund – State) $15,510,000
WMCC Implementation Plan: Funding is provided for the department, in collaboration with the Washington Medical Coordination Center (WMCC), to create an implementation plan for real-time bed capacity and tracking for hospitals, excluding behavioral health hospitals and facilities and skilled nursing facilities. The department will provide the implementation plan and estimated costs for an information technology system and implementation costs to the Office of Financial Management by September 15, 2023 for the bed capacity and tracking tool. (General Fund – State) $200,000
Hospital Staffing Standards: Funding is provided for implementation of Engrossed Second Substitute Senate Bill 5236 (Hospital staffing standards), which modifies nurse staffing committee and staffing plan requirements and makes changes to meal and rest breaks and overtime provisions for health care employees. (Health Professions Account-State) $4,787,000
Multistate nurse licensure: Funding is provided to DOH to implement Substitute Senate Bill 5499 (Multistate nurse licensure). (Health Professions Account-State) $1,205,000
Forensic Pathologists: Funding is provided for the implementation of Substitute Senate Bill 5523 (Forensic pathologist), which establishes a forensic pathologist loan repayment program. (General Fund-State) $222,000
Preventable Hospitalizations: Funding is provided to continue the collaboration between the local health jurisdiction, related accountable communities of health, and health care providers to reduce potentially preventable hospitalizations in Pierce County. (General Fund-State) $1,500,000
WSHA Clinical Placement: Funding is provided for DOH to contract with the central nursing resource center to gather data to assess current clinical placement practices and identify policy options and recommendations to help increase the number of clinical placement opportunities (General Fund-State) $560,000
Naloxone Distribution: Ongoing funding is provided for the distribution of naloxone through DOH’s overdose education and naloxone distribution program. Funding must be prioritized to fill naloxone access gaps in community behavioral health and other community settings, including providing naloxone for first responders and agency staff in organizations such as syringe service programs, housing providers, and street outreach programs. (Opioid Abatement Settlement Account-State) $5,000,000
Opioid Remediation: Funding is provided for prevention, treatment, and recovery support services to remediate the impacts of the opioid epidemic. This funding shall be used consistent with conditions of opioid settlement agreements which direct how funds deposited into the Opioid Settlement Account created in Engrossed Substitute Senate Bill 5293 (Accounts) shall be used. (Opioid Abatement Settlement Account-State) $2,000,000
Health Care Authority
Professional Services Rates: Funding is provided to increase physician and professional rates for certain service categories to the Medicare rate beginning July 1, 2024. (General Fund-State; General Fund-Medicaid) $31,980,000
Opioid settlement fentanyl public education: Funding is provided for development of a health promotion and education campaign, with a focus on synthetic drug supplies, including fentanyl, and accurate harm reduction messaging for communities, law enforcement, and others. (Opioid Abatement Settlement Account-State) (One-Time) $2,000,000
Opioid settlement Prevention Services Fund Shift: The Partnership for Success (PFS) program provides services that address underage drinking, cannabis/tobacco prevention, and opioid/prescription drug misuse among individuals between the ages of 12 and 25. State funding is provided to continue this prevention program that was originally funded through a 5-year PFS federal grant. (Opioid Abatement Settlement Account-State) (Ongoing) $2,000,000
Opioid settlement SUD Prev., Outreach, Tx, Recovery: Funding is provided for HCA to contract for opioid prevention, outreach, treatment, or recovery support services that are not reimbursable under the state Medicaid plan. Of these amounts, $500,000 is provided for Spanish language opioid prevention services. (Opioid Abatement Settlement Account-State) (Ongoing) $3,000,000
Opioid settlement prescription opioid education: Funding is provided for the HCA to contract with programs to prevent inappropriate opioid prescribing at the following sites: 1) Washington State University’s College of Nursing; 2) the Washington State Medical Association and the Washington State Hospital Association’s Joint Better Prescribing Better Treatment initiative; and 3) the Department of Labor and Industries and the University of Washington’s joint Occupational Epidemiology and Health Outcomes Program. (Opioid Abatement Settlement Account-State) (Ongoing) $1,830,000
Opioid settlement MOUD in jails technical support: Funding is provided for technical assistance for improving access to Medication for Opioid Use Disorder (MOUD) in jails and to support efforts for jails to navigate regulatory pharmacy and health care requirements related to these services. (Opioid Abatement Settlement Account-State) (Ongoing) $538,000
Difficult to Discharge Pilot: One-time funding is provided for incentive payments, administrative support, and development of home and community assessment timeliness requirements for pilot participants in cooperation with the Department of Social and Health Services for a five-site pilot program for difficult to the discharge individuals. (General Fund State; General Fund-Medicaid) (One-Time) $22,549,000
Behavioral Health Institute: Funding is provided on a one-time basis for the University of Washington Behavioral Health Institute to continue and enhance its efforts related to behavioral health training and workforce development. (General Fund-Federal) $1,500,000
Higher education and workforce
UW Hospital Support: One-time funding is provided for continued support of operations and teaching activities at the University of Washington (UW) Medical Center and Harborview Medical Center in fiscal years 2023-2024. (General Fund-State; Coronavirus State Fiscal Recovery Fund-Federal) $150,000,000
Adult psychiatry residency: Provided to offer additional residency positions for the adult psychiatry residency program at UW. $1,200,000
Difficult to Discharge Pilot (UW): One-time funding is provided to organize and facilitate a difficult to discharge task force to oversee a pilot program and make recommendations about how to address challenges faced with discharging patients from acute care settings and post-acute care capacity. (General Fund-State) (One-Time) $205,000
Family Medicine Residency Program (UW): Funding is provided to expand the Family Medicine Residency Program. (Education Legacy Trust Account-State) (Ongoing) $10,000,000
Nursing Education (UW): Funding is provided for continued support for additional nursing slots in the existing accelerated Bachelor of Science in Nursing program at the Seattle campus and the School of Nursing and Healthcare Leadership at the Tacoma campus. A coordinated progress report with the Student Achievement Council is due to the Legislature by June 1, 2023, and a final report is due by December 1, 2024. (General Fund-State) (Ongoing) $742,000
Nursing Education (Community and Technical College System): Funding is provided to increase the number of slots in nursing programs by 200 in the 2023-25 biennium. A coordinated progress report with the Student Achievement Council is due to the Legislature by June 1, 2023, and a final report is due by December 1, 2024. (Workforce Education Investment Account-State) (Ongoing) $3,600,000
Nurse Supply (Community and Technical College System): Funding is provided for the State Board for Community and Technical Colleges (SBCTC) to develop a plan to train more nurses and to design and implement an online curriculum and pathway to earn a licensed practical nursing credential, as provided in SB 5582 (Nurse supply). A report on the plan is due to the Legislature by December 1, 2024. (General Fund-State) (Custom) $882,000
Hospital Staffing Standards (Evergreen): Funding is provided for the Washington State Institute for Public Policy (WSIPP) to conduct a hospital staffing standards study as required in SB 5236 (Hospital staffing standards). A report is due by June 30, 2024. (General Fund-State) (One-Time) $163,000
Department of Corrections
Addiction care delivery: This item will expand the addiction treatment program at the Department of Corrections to increase access for incarcerated individuals diagnosed with a substance use disorder. The expansion includes employing dedicated addiction treatment medical staff throughout the agency and greater use of medications for opioid use disorder to reduce mortality rates after release. (General Fund – State) $3,964,000
Reentry investments to include reentry and discharge services: The staffing and resources must provide expanded reentry and discharge services to include, but not limited to, transition services, enhanced health care discharge planning, case management, and evaluation of physical and behavioral health $4,348,000
Attorney General
Firearms Industry Duties: Funding is provided for the Attorney General’s Office (AGO) to investigate and enforce Substitute Senate Bill 5078 (Firearms industry duties), which imposes duties on firearm industry members to establish, implement and enforce reasonable controls regarding the manufacture, sale, distribution, import, use, and marketing of its products and prohibits firearm industry members from creating or maintaining a public nuisance. (General Fund State) $2,798,000
Hospital Staffing Standards: Funding is provided for legal services to agencies to implement Engrossed Second Substitute Senate Bill 5236 (Hospital staffing standards), which modifies nurse staffing committee and staffing plan requirements and makes changes to meal and rest breaks and overtime provisions for health care employees. (Legal Services Revolving Account-State) $204,000
Department of Commerce
Funding for the Office of Firearm Safety and Violence Prevention. $12,036,000
Office of Financial Management
Difficult to discharge taskforce, to include representatives from the Washington State Hospital Association and post-acute care provider organizations (among others). $1,025,000
Foundational public health: Funding provided in accordance with RCW 43.70.515 to support foundational public health services statewide. $301,164,000
Department of Revenue
Wealth tax study: One-time funding is provided for the Department of Revenue to research and analyze wealth taxes imposed in other countries and wealth tax legislation recently proposed by other jurisdictions. $300,000

Legislation of Note

Firearm violence

  • HB 1240 – Assault weapons ban (Peterson)
    • Bill Passed
    • This bill generally prohibits the manufacture and sale of semi-automatic “assault weapons,” including firearms such as the AR-15 and AK-47.
    • Why is this important?
      • Assault weapons are exceptionally deadly firearms commonly used in mass shootings.
  • HB 1143 – Firearm purchase requirements (Berry)
    • Bill Passed
    • To be eligible to purchase firearms, this bill requires individuals to have recently completed a firearm safety training program and undergo a background check and 10-day waiting period.
    • Why is this important?
      • Background checks and waiting periods for the purchase of firearms are proven to help prevent gun violence.
  • SB 5078 – Firearm industry liability (Pedersen)
    • Bill Passed
    • This bill establishes “reasonable controls” on firearm industry members to comply with state and federal firearm laws and prevent diversion of firearms. A right of action is created against firearm industry members in circumstances where violence results from their conduct such as advertising targeted at minors and promoting the illegal conversion of firearms.
    • Why is this important?
      • With the passage of this bill, Washington joins a growing number of states that have established that the gun industry can be held legally labile for gun violence.

Abortion, reproductive health, and gender-affirming care

  • HB 1340 – Medical license protections (Riccelli)
    • Bill Passed
    • This bill establishes that the performance of reproductive health and gender affirming care services consistent with Washington state standards of care (even in a state where such services are prohibited) does not qualify as unprofessional conduct under the Uniform Discipline Act for the purpose of Washington state licensure and discipline.
    • Why is this important?
      • Physicians should be able to provide the full range of health care services to their patients without fear of jeopardizing their medical license. While the Washington Legislature cannot address the laws of other states, HB 1340 ensures that our current physician community and those who move here are protected from negative licensure actions in the state of Washington.
  • HB 1469 – Shield law (Hansen)
    • Bill Passed
    • This bill establishes liability protections for patients and health care professionals from criminal and civil actions based on the provision or receipt of abortion services and gender affirming care consistent with Washington state law. This includes prohibiting law enforcement from participating in investigations and the courts from imposing penalties of other states, among other actions. The bill also makes health care professionals eligible for the state’s Address Confidentiality Program.
    • Why is this important?
      • The U.S. Supreme Court’s Dobbs decision has resulted in a patchwork of evolving legalities across the country, with some states establishing additional protections for abortion services while others move to criminalize or impose civil infractions associated with such care. The purpose of this bill is to insulate Washington state health care professionals and patients to the extent possible from the restrictive actions of other states.
  • SB 5242 – Abortion cost-sharing (Cleveland)
    • Bill Passed
    • Beginning January 1, 2024, this bill generally prohibits the imposition of cost-sharing for abortion services.
    • Why is this important?
      • Despite access to abortion services remaining legal in Washington, cost remains a significant barrier to access to care and exacerbates existing health disparities.
  • SB 5768 – Mifepristone access (Keiser)
    • Bill Passed
    • This bill gives the Department of Corrections the authority to distribute and sell mifepristone to health care providers and clinics around the state.
    • Why is this important?
      • As of this writing, legal cases are pending that challenge the FDA’s approval of mifepristone, which could also have an impact on manufacturing of the drug. In order to ensure continued access, the state purchased a three-year supply of mifepristone to be stored and distributed by the DOC through its existing pharmacy infrastructure.

Mental/behavioral health

  • SB 5120 – 23-hour crisis relief centers (Dhingra)
    • Bill Passed
    • This bill directs the Department of Health to license or certify 23-hour crisis relief centers, a new type of crisis diversion facility, to provide services to address mental health and substance use crisis issues (among other conditions), coordinating connections to ongoing care when appropriate.
    • Why is this important?
      • There is a significant need to expand resources for urgent behavioral health care services.

Scope of practice

  • SB 5389 – Optometry (Cleveland)
    • Bill Passed
    • This bill expands scope of practice for optometrists to include increased prescriptive authority, the ability to perform certain surgical procedures and to provide injections (among other provisions). Led by the ophthalmologists, the physician community was successful in advocating to narrow the bill from the form in which it was introduced, notably to remove the ability of optometrists to perform laser procedures.
    • Why is this important?
      • There are few, if any, functions of the human body more important to a person’s quality of life than their ability to see the world clearly and without pain. The complications that can arise during eye surgery are serious and often irreversible. Optometrists are valued members of the health care team, but their education and training does not prepare them to perform surgical procedures.
  • HB 1310 & SB 5633 – Physician assistants (Riccelli & Conway)
    • Bills Died
    • These bills would have removed the requirement that physician assistants practice under the supervision of a physician, allowing physician assistants to work in collaboration agreements with an employer or one or more physicians.
    • Why is this important?
      • Among the physician community there were concerns about the broad proposed nature of collaboration agreements under these bills.
  • SB 5411 – Naturopathy (Short)
    • Bill Died
    • This bill would have expanded the scope of practice for naturopaths to include increasing their prescriptive authority to encompass all drugs in schedules II through V (including opioids), broadened their ability to perform “minor office procedures” to include all primary care services, and allowed them to sign an attestation to any document that a physician may sign that’s within the naturopath’s scope of practice.
    • Why is this important?
      • Among other concerns, a naturopath’s education and training does not include the comprehensive medical and pharmacological background needed to prescribe potentially dangerous drugs.
  • SB 5373 & HB 1495 – ARNP reimbursement mandate (Randall & Simmons)
    • Bills Died
    • These bills would have required insurance carriers to reimburse advanced registered nurse practitioners and physician assistants at the same rate as physicians for providing the same service in the same service area.
    • Why is this important?
      • The physician community has sought to ensure the ability of insurance carriers to make distinctions in reimbursement to recognize distinctions in skill, training and expertise between physicians and other providers of health care.
  • HB 1041 – Psychologist prescriptive authority (Bateman)
    • Bill Died
    • This bill would have granted psychologists the authority to prescribe psychotropic drugs upon the attainment of certain education and training and when working in “an ongoing collaborative relationship” with a health care provider who oversees the patient’s general medical care.
    • Why is this important?
      • Psychologists have an important role in the treatment of mental and behavioral health conditions. This bill would have had the effect of increasing access to psychotropic drugs but would not have necessarily increased access to care. Given the patient safety concerns raised, the potential for harm outweighed any benefit that could have been achieved.
  • HB 1038 & SB 5184 – Anesthesiologist assistants (Taylor & Rivers)
    • Bills Died
    • These bills would have established the licensure and scope of practice for anesthesiologist assistants, who would be licensed by the Washington Medical Commission to assist in developing and implementing anesthesia care plans for patients under the supervision of an anesthesiologist or group of anesthesiologists.
    • Why is this important?
      • A growing number of states have helped address anesthesia workforce needs by licensing anesthesiologist assistants, who provide high-quality patient care working in physician-led care teams.
  • HB 1073 – Medical assistants (Harris)
    • Bill Passed
    • This bill makes several changes to the circumstances under which medical assistants may work, allowing MAs to work while being certified, allowing medical assistants-registered to administer intramuscular injections under the general (rather than “direct visual) supervision of a health care professional, and allowing medical assistants-certified to work under the general (rather than “direct visual”) supervision of a health care professional when administering IV injections for diagnostic or therapeutic agents.
    • Why is this important?
      • These changes will help address workforce strain by updating MA regulations to reflect their education and training and in some circumstances to align with flexibilities that were established during the pandemic. The WSMA secured changes to the bill that ensured important patient safety guardrails.


  • HB 1850 – Hospital safety net assessment (Macri)
    • Bill Passed
    • This bill updates the state’s hospital safety net assessment, which is a system by which revenues from taxes levied on hospitals are returned to hospitals in the form of increased Medicaid reimbursement rates (among other appropriations). Established for hospitals in 2010, the safety net assessment model has subsequently been used to increase Medicaid rates for nursing homes and ambulances. HB 1850 increases revenue associated with the assessment and makes it permanent. The bill maintains investments in physician residencies through the assessment, totaling $4.1 million for family medicine residencies and $2 million for integrated psychiatry residencies in each two-year state budget cycle.
    • Why is this important?
      • Like Medicaid reimbursement rates for physicians, rates paid to hospitals fail to cover the cost of delivering care and hadn’t been updated in decades. The state has an obligation to ensure access to care for Medicaid enrollees. Utilizing safety net assessments can increase revenues into the Medicaid program and in turn facilitate rate increases.
  • SB 5767 – Highly compensated hospital employee tax (Randall)
    • Bill Did Not Get Consideration
    • This bill would have levied a tax of 7.5 percent on the “excess compensation” of a hospital’s five highest compensated employees who make more than ten times the state’s average wage and who do not have any direct patient responsibilities.
    • Why is this important?
      • While the bill was introduced late in session and did not get consideration this year, it signals a broader interest from majority party Democrats to explore additional excise tax options following the state Supreme Court’s recent ruling that it is constitutional to apply excise tax to income.
  • SB 5523 – Forensic pathologists (Dhingra)
    • Bill Passed
    • This bill establishes a loan repayment program for forensic pathologists, with awards to eligible board-certified forensic pathologist applicants of up to $25,000 for up to four years. It also requires a study on the shortage of forensic pathologists, with recommendations due to the Legislature later this year.
    • Why is this important?
      • Like many other states, Washington is currently facing an acute shortage of trained forensic pathologists.

Business & liability

  • SB 5241 & HB 1263 – Mergers and affiliations (Randall & Simmons)
    • Bills Died
    • These bills would have imposed numerous new restrictions and requirements on the ability of physician organizations, hospitals, and other entities to enter into partnerships such as mergers and sales.
    • Why is this important?
      • This proposal would have jeopardized the financial viability of physician practices in limiting their ability to partner with other organizations. If physician organizations were forced to go out of business rather than entering into partnerships it could have the effect of limiting access to care in communities.
  • HB 1508 & SB 5519 – Health Care Cost Transparency Board (Macri & Robinson)
    • Bills Died
    • These bills would have, among other provisions, authorized the state’s Health Care Cost Transparency Board to subject health care professionals, health care facilities, and insurance carriers to discipline and fines in the event they exceed the “benchmark” rate for increases in health care costs (set at 3.2 percent annually, decreasing to 2.8 percent by 2026). The bill also granted the HCCTB authority to mandate data collection from physician organizations and other entities.
    • Why is this important?
      • Granting the HCCTB sweeping powers so recently after its 2020 enactment and before it has accomplished the initial tasks it was charged with is premature. Further, the benchmarks for health care cost increases established by the HCCTB are unrealistic and subjecting physician organizations to fines based on the benchmark is inappropriate.
  • SB 5236 – Nurse staffing (Robinson)
    • Bill Passed
    • This bill generally revises provisions related to hospital staffing committees to direct their operations, increase representation of nurses that provide direct patient care, and to assess fines for circumstances where a hospital is operating without a current staffing plan.
    • Why is this important?
      • This bill represents a compromise between relevant stakeholders, opting to establish additional requirements for the existing hospital staffing committee system, among other provisions. As originally introduced, WSMA opposed language that would have mandated nurse to patient staffing ratios due to concerns about potential adverse impact on access to care.

Prior authorization

  • HB 1357 – Prior authorization modernization (Simmons)
    • Bill Passed
    • WSMA brought forward this priority legislation to modernize and standardize insurance carrier prior authorization practices. HB 1357 expedites turnaround times for all prior authorizations and mandates that insurance carriers develop electronic processes for prior authorization that integrate into electronic medical records for both health care services (by 1/1/25) and prescription drugs (by 1/1/27). The bill also mandates that insurance carriers base their prior authorization requirements on peer-reviewed clinical review criteria and update it regularly.
    • Why is this important?
      • Prior authorization delays patients’ access to care, drives cost and administrative burden for physicians, and diverts health care work force from care delivery. Reforming prior authorization has consistently been identified by the physician community as a top priority for our legislative advocacy.