This bill establishes new regulations governing the relationships between health carriers and contracting providers in Washington State. It mandates that health carriers must offer providers a meaningful opportunity for good faith negotiations before entering into or renewing contracts. Key provisions include requirements for health carriers to provide contact information for negotiations, furnish updated contract copies with changes clearly indicated, and supply fee schedules at least 60 days prior to contract execution. Additionally, the bill prohibits certain contract clauses, such as all-or-nothing clauses and discounted rate requirements for services under other health plans. Violations of these provisions may result in fines of up to $5,000 per violation and corrective action orders from the commissioner.

The bill also requires the insurance commissioner to analyze and report on trends in allowed amounts for commonly billed procedures using data from the statewide all-payer health care claims database, with annual reports due starting January 1, 2027, and expiring on January 31, 2031. The commissioner is granted the authority to adopt necessary rules for implementation, and the act will take effect on January 1, 2027, unless specific funding is not provided by June 30, 2025, in which case the act will be null and void.

Statutes affected:
Original Bill: 48.49.135
Substitute Bill: 48.49.135
Second Substitute: 48.49.135