Washington SB5395: Prior authorization/health

What the bill says

An act Relating to making improvements to transparency and accountability in the prior authorization determination process; amending RCW 48.43.830, 74.09.840, 41.05.845, 48.43.525, and 48.43.0161; and creating a new section. NEW SECTION.

From the introduced text:

AN ACT Relating to making improvements to transparency and accountability in the prior authorization determination process; amending RCW 48.43.830, 74.09.840, 41.05.845, 48.43.525, and 48.43.0161; and creating a new section. NEW SECTION. Sec. 1. (1) The legislature finds that health insurance carriers, health plans, and managed care organizations are the decision makers for the type and level of care covered for an enrollee's health care benefits and are not responsible for determining or altering an enrollee's diagnosis or treatment plan. It is not always transparent who the decision maker is or how decisions are made in determining enrollee coverage for treatment, prescription drugs, or services. Artificial intelligence is being increasingly utilized by carriers, health plans, and managed care organizations to make or aid in decisions about medical necessity and coverage of provider-recommended treatment. (2) It is the intent of the legislature to increase transparency in the prior authorization process for health care coverage decisions and to ensure licensed physicians and licensed health professionals remain responsible for making determinations about coverage for treatment, prescription drugs, and services that are medically necessary. If artificial intelligence is used to aid in the decision-making process, standards must be put in place to ensure artificial intelligence is not used to make inappropriate determinations that could impact the health of an enrollee. Sec. 2. RCW 48.43.830 and …

Read the full official text

Sponsors

• Tina Orwall (D) · primary sponsor
• Ron Muzzall (R)
• Robert Hasegawa (D)
• Liz Lovelett (D)
• T'wina Nobles (D)
• Vandana Slatter (D)

Latest actions

1. March 23, 2026: Effective date 6/11/2026*.
2. March 23, 2026: Chapter 157, 2026 Laws.
3. March 23, 2026: Governor signed.
4. March 12, 2026: Delivered to Governor.
5. March 11, 2026: Speaker signed.
6. March 10, 2026: President signed.
7. March 9, 2026: Passed final passage; yeas, 49; nays, 0; absent, 0; excused, 0.
8. March 9, 2026: Senate concurred in House amendments.
9. March 4, 2026: Third reading, passed; yeas, 94; nays, 0; absent, 0; excused, 4.
10. March 4, 2026: Rules suspended. Placed on Third Reading.

Votes

• Final Passage as Amended by the House (March 9, 2026): 49 yea, 0 nay, passed
• Final Passage as Amended by the House (March 4, 2026): 94 yea, 0 nay, passed
• House Committee on Appropriations: Do pass as amended by Committee on Appropriations and without amendment by Committee on Health Care & Wellness (March 2, 2026): 29 yea, 0 nay, passed
• House Committee on Health Care & Wellness: Do pass as amended (February 25, 2026): 16 yea, 0 nay, passed
• 3rd Reading & Final Passage (February 11, 2026): 48 yea, 1 nay, passed
• Senate Committee on Ways & Means: That Second Substitute Senate Bill No. 5395 be substituted therefor, and the second substitute bill do pass (January 27, 2026): 21 yea, 0 nay, passed

Common questions

What is SB5395?

SB5395 is a bill in the Washington Legislature (2025-26 Regular Session): Prior authorization/health.

What does SB5395 do?

In its own words: An act Relating to making improvements to transparency and accountability in the prior authorization determination process; amending RCW 48.43.830, 74.09.840, 41.05.845, 48.43.525, and 48.43.0161; and creating a new section. NEW SECTION.

What is the status of SB5395?

Signed into law as of March 23, 2026. Latest action: Effective date 6/11/2026*. (March 23, 2026).

Who sponsored SB5395?

Tina Orwall (D), with 5 co-sponsors.

Where is the official record for SB5395?

On the Washington Legislature website: https://app.leg.wa.gov/billsummary?BillNumber=5395&Year=2025