The bill aims to modernize and clarify the timely payment requirements for health carriers in Washington State, addressing the financial vulnerabilities faced by healthcare providers and facilities due to delays in claims processing. It establishes a new section in chapter 48.43 RCW that mandates health carriers to pay or deny claims for healthcare services within specific timeframes: 30 calendar days for clean claims and 21 calendar days for non-clean claims, during which carriers must provide remittance advice or electronic notice to the provider. Additionally, the bill introduces interest penalties for carriers that fail to comply with these timelines, with rates escalating after 60 days of non-compliance.

The bill also amends existing laws, including RCW 41.05.017 and RCW 48.43.600, to reflect these new requirements. Notably, it reduces the timeframe for carriers to request refunds from providers from 24 months to 12 months for general claims and from 30 months to 18 months for coordination of benefits claims. The provisions of this act will apply to health plans filed or renewed on or after January 1, 2027, and it excludes Medicaid managed care plans. The bill emphasizes the responsibility of health carriers to ensure compliance and allows the insurance commissioner to enforce these regulations.

Statutes affected:
Bill as passed Legislature: 48.43.600
Session law: 48.43.600