Concerning the relationships between health carriers and contracting providers.

 S-0972.1

SENATE BILL 5588

State of Washington

69th Legislature

2025 Regular Session

By Senators Cleveland, Nobles, and Short

Read first time 01/30/25. Referred to Committee on Health & Long-Term Care.

AN ACT Relating to the relationships between health carriers and contracting providers; amending RCW 48.49.135 ; adding a new section to chapter 48.43 RCW; creating a new section; and providing an effective date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1. RCW 48.49.135 and 2022 c 263 s 18 are each amended to read as follows:

(1) When determining the adequacy of a proposed provider network or the ongoing adequacy of an in-force provider network, the commissioner must review the carrier's proposed provider network or in-force provider network to determine whether the network includes a sufficient number of contracted providers of emergency medicine, anesthesiology, pathology, radiology, neonatology, surgery, hospitalist, intensivist(( [,] )) , and diagnostic services, including radiology and laboratory services at or for the carrier's contracted in-network hospitals or ambulatory surgical facilities to reasonably ensure enrollees have in-network access to covered benefits delivered at that facility.