Senate Bill 5,324, a proposed substitute that would align Washington’s prior‑authorization API requirements with recently finalized federal rules, was the subject of a committee briefing and public testimony on Feb. 7 before the Senate Health & Long Term Care Committee.

Committee staff explained the substitute would remove many detailed state‑level prescription requirements for prior‑authorization APIs and instead require that APIs be “consistent with the final rules issued by CMS.” The substitute also pushes the state implementation date to Jan. 1, 2027, after federal rules and implementation guides are in place.

Industry and provider witnesses supported alignment and the extended timeline. Jennifer Ziegler of the Association of Washington Healthcare Plans said the substitute is “as tailored as narrowly as possible to be focused only on making sure that the date is consistent with the federal timeline of 01/01/2027.” Christine Brewer of Premera Blue Cross and Heidi Kriz of Regence told the committee that prior‑authorization interoperability has reduced administrative burden in pilots and early deployments: Regence said providers in its pilot receive immediate responses 94% of the time, and that 85% of inbound queries show the requested service does not require prior authorization once records are checked via API.

Proponents said APIs will reduce reliance on faxed requests — testimony showed about 45% of prior‑authorization requests still arrive by fax — and speed determinations by pulling clinical data from the provider’s electronic medical record into standardized API exchanges.

Hospital and provider witnesses asked for clarifications on how the state and federal rules will align, urged flexibility for different hospital and provider IT environments, and requested minor technical fixes to exemptions and definitions. Shawn Graham of the Washington State Medical Association and Lisa Thatcher of the Washington State Hospital Association expressed support for the policy goal and requested targeted clarifying amendments to ensure the law’s effective operation when the federal standards are implemented.

Ending: Testimony showed broad stakeholder support for aligning Washington’s timeline with federal rules and for giving plans and providers time to implement interoperable prior‑authorization APIs. The committee did not take a vote at the hearing and sponsors said they would continue technical discussions with stakeholders.