Latest / Health and life sciences

Washington law says only a licensed clinician can deny prior-authorisation requests

Rule changeHealthFinanceUS-WA USConfirmed

Washington's governor signed SB 5395 (Chapter 157, Laws of 2026), which passed with unanimous final votes in both chambers and requires that only a licensed physician or health professional may deny a request on medical-necessity grounds, barring AI from being the sole basis for denial; it took effect on 11 June 2026. It is one of at least seven 2026 state laws, alongside Alabama, Colorado, Georgia, Illinois, Iowa and Utah, limiting AI in insurers' coverage decisions.

Why it matters

Insurers and AI vendors must build human sign-off and audit trails into utilisation-review tools, state by state.

SourceWashington State LegislatureCoverage: Becker's Payer Issues Checked against the primary source. Independently fact-checked on 7 Oct 2026.
Washington State Legislature

Line of Thought

Follow this story

Pick any item to keep going. Your path builds up above as a line you can share.

Curated lines through this story

Can an algorithm deny your care?Stop 5 of 7

Directly linked

Connections our researchers recorded

What led here

Earlier developments on the same thread

What happened next

Later developments on the same thread

Same story elsewhere

What other countries and bodies did on this

Rules in play

Laws and guidance this touches

Threads by topic: Courts and liability Financial risk Clinical AI