State Law

Revised Code of Washington-Title 48-Chapter 48.43. Insurance Reform

08/26/2023 Washington Section 48.43.525

Prohibition against retrospective denial of health plan coverage — Rules.

Retroactive Denial

(1) A health carrier that offers a health plan shall not retrospectively deny coverage for emergency and nonemergency care that had prior authorization under the plan’s written policies at the time the care was rendered.

(2) The commissioner shall adopt, in rule, standards for this section after considering relevant standards adopted by national managed care accreditation organizations and state agencies that purchase managed health care services.