| notice_of_proposed_amendments_to_the_wsma_bylaws_for_2025 | Notice of Proposed Amendments to the WSMA Bylaws for 2025 | Leadership | Shared_Content/News/Latest_News/2025/notice_of_proposed_amendments_to_the_wsma_bylaws_for_2025 | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/news/AM-2025-Graphic-V2 2.png" class="pull-right" alt="2025 WSMA Annual Meeting" /></div>
<h5>June 30, 2025</h5>
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<h2>Notice of Proposed Amendments to the WSMA Bylaws for 2025 </h2>
<p>The WSMA Bylaws Committee hereby provides notice of its proposals to amend the <a href="[@]wsma/about/policies/policies.aspx">WSMA bylaws</a> (as required by Article XIX of the bylaws). The committee will introduce the proposed amendments listed below at the 2025 House of Delegates meeting this fall.</p>
<p>Proposed amendments to the bylaws for 2025 include changes that would:</p>
<ul>
<li>Include retired members (currently “Senior Membersâ€) in delegate counts for component county societies, in addition to active and active limited members already included.</li>
<li>Establish a standing Diversity, Equity, Inclusion, and Belonging Committee, defining the composition of the committee, outlining the purpose and duties of the committee, and establishing that the committee chair will be elected by the House of Delegates and serve on the WSMA board of trustees.</li>
<li>Establish that WSMA members who either reside or practice in a county without an active medical society may participate in the WSMA as “Direct Members†who are represented at the House of Delegates in an “Inactive County Section.†The section will be entitled to one delegate and one alternate for each 50 members, or fraction thereof, in the section.</li>
<li>Amend the current bylaws language on “Senior Members†to update terminology, changing “Senior Members†to “Retired Members,†and clarify that retired members must have met all requirements for being an active member prior to their retirement, including the requirement to principally reside or practice in Washington.</li>
</ul>
<p>Read the 2025 bylaws amendments in full:</p>
<ul>
<li><a href="javascript://[Uploaded files/News and Publications/newsletters/2025/Updated B-5 Bylaws Report.06262025.pdf]">Bylaws Amendment Pursuant to Resolution B-5—Inactive Counties Section to the House of Delegates</a></li>
<li><a href="javascript://[Uploaded files/News and Publications/newsletters/2025/Updated B-13 Bylaws report.06262025.pdf]">Bylaws Amendment Pursuant to Resolution B-13—Diversity, Equity and Inclusion Standing Committee</a></li>
<li><a href="javascript://[Uploaded files/News and Publications/newsletters/2025/Updated B-20 Bylaws Report.06262025.pdf]">Bylaws Amendment Pursuant to Resolution B-20—Reinforce and Clarify Residency and Practice Requirements for the WSMA Board of Trustees</a></li>
<li><a href="javascript://[Uploaded files/News and Publications/newsletters/2025/Updated Delegate Count Bylaws Report.06262025.pdf]">Bylaws Amendment to Include Senior/Retired Members in Delegate Counts</a></li>
</ul>
<p> These proposed changes will be presented to the WSMA House of Delegates for adoption at the&nbsp;<a href="http://www.wsma.org/wsma/events/annual_meeting/annual_meeting.aspx">2025 Annual Meeting of the WSMA House of Delegates, Sept. 20-21 in Bellevue</a>.</p>
</div> | 7/11/2025 9:50:10 AM | 1/1/0001 12:00:00 AM |
| ceo-rounds-june-27-2025-talk-and-action-on-prior-authorization | CEO Rounds: June 27, 2025 - Talk and Action on Prior Authorization | Leadership | Shared_Content/News/ceo-rounds/2025/ceo-rounds-june-27-2025-talk-and-action-on-prior-authorization | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/ceo-rounds/ceo-rounds-article-graphic-2025-1290x850px.png" class="pull-right" alt="CEO Rounds with Jennifer Hanscom graphic" /></div>
<h5>June 27, 2025</h5>
<h2>Talk and Action on Prior Authorization</h2>
<p>Jennifer Hanscom, CEO</p>
<p>
Prior authorization is once again making headlines, this time as the Association of Health Insurance Plans announced on Monday "a series of commitments to streamline, simplify and reduce prior authorization." In its <a href="https://www.ahip.org/news/press-releases/health-plans-take-action-to-simplify-prior-authorization">release</a>, AHIP shared that participating health plans commit to standardize and reduce the scope of claims subject to prior authorization.
</p>
<p>
The several measures will apply to employer-sponsored plans, Medicaid and Medicare, and plans offered by the state's exchange program.
</p>
<p>
While Secretary of Health Robert F. Kennedy, Jr., and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz praised the move, many others are taking a wait-and-see approach.
</p>
<p>
Back in 2017, the WSMA joined the American Medical Association and 16 state and specialty medical societies, national associations, and patient representatives in developing <a href="https://www.ama-assn.org/system/files/principles-with-signatory-page-for-slsc.pdf" target="_blank" rel="noreferrer">best practices for prior authorization</a> and other utilization management requirements. The release of the 21 prior authorization reform principles initiated meaningful discussions with the health insurance industry about reducing prior authorization burdens resulting in the <a href="https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/arc-public/prior-authorization-consensus-statement.pdf" target="_blank" rel="noreferrer">Consensus Statement on Improving the Prior Authorization Process</a> in 2018, created by the AMA, American Hospital Association, AHIP, American Pharmacists Association, BlueCross BlueShield Association, and Medical Group Management Association. Insurance carriers have <a href="https://www.fiercehealthcare.com/payers/ama-charges-payers-not-following-prior-authorization-reforms-they-agreed-2018#:~:text=The%202018%20agreement%20between%20the,yet%20to%20fully%20take%20hold.">since been criticized</a> for not following through with this pledge.
</p>
<p>
Putting this statement into action, the WSMA has worked to pass policies that have put Washington state at the forefront of states regulating prior authorization processes. Most recently, that includes legislation establishing some of the shortest turnaround times in the nation.
</p>
<p>
Effective as of Jan. 1, 2024, time frames for both electronic and nonelectronic requests and standard and expedited requests have been shortened to ensure timely patient access to care. Washington state's prior authorization reforms only apply to commercial plans regulated by our Office of Insurance Commissioner. ERISA plans are exempt.
</p>
<ul>
<li>
<strong>Standard electronic prior authorization requests</strong><br />
For a standard electronic prior authorization request, an insurer must make a decision within three calendar days. If additional information is needed to make a determination, the health carrier must request it within one calendar day of the submission of the request.
</li>
<li>
<strong>Expedited electronic prior authorization requests</strong><br />
For an expedited electronic prior authorization request, the insurer must make a decision within one calendar days. If additional information is needed to make a determination, the health carrier must request it within one calendar day of the submission of the request.
</li>
<li>
<strong>Standard nonelectronic prior authorization requests</strong><br />
For a standard nonelectronic prior authorization request, an insurer must make a decision within five calendar days. If additional information is needed to make a determination, the health carrier must request it within five calendar days of the submission of the request.
</li>
<li>
<strong>Expedited nonelectronic prior authorization requests</strong><br />
For an expedited nonelectronic prior authorization request, an insurer must make a decision within two calendar days. If additional information is needed to make a determination, the health carrier must request it within one calendar day of the submission of the request.
</li>
</ul>
<p>
The Office of the Insurance Commissioner clarifies that under current law, insurance carriers and third-party administrators are not permitted to require prior authorization for emergency services.
</p>
<p>
Additionally, no prior authorization is needed for "extenuating circumstances." Extenuating circumstances are unforeseen situations where the time frames for both standard and expedited prior authorization are insufficient for a physician to receive approval prior to the delivery of a service. You can read more about what classifies as an extenuating circumstance in <a href="https://priorauth.wsma.org/?_zs=B3aFd1&amp;_zl=B1IHA">WSMA's Prior Authorization Navigator</a>.
</p>
<p>
<a href="https://app.leg.wa.gov/billsummary/?BillNumber=1706&amp;Year=2025&amp;Initiative=false">By 2027</a>, carriers in Washington state must build and maintain a prior authorization application programming interface or interoperable electronic process that automates for in-network providers the prior authorization process via electronic health records or practice management system.
</p>
<p>
The new application programming interface requirement will facilitate the process for determining the necessity of a prior authorization, provide information on documentation requirements, and assist with communications between a carrier and the provider or facility, such as requests and determinations. Additional details on new electronic standards are forthcoming. Many of these advancements were made possible by annual data collected by the OIC per WSMA-supported Senate Bill 6404 in 2020, which has illustrated reviews may be administrative formalities rather than true clinical reviews, supporting to the need for these prior authorization reforms.
</p>
<p>
While prior authorization will continue to make <a href="https://www.nbcnews.com/health/health-care/prior-authorization-insurance-denials-patients-treatment-rcna212068">national headlines</a>, the WSMA will continue to advocate locally for change. As covered in our <a href="[@]wsma/advocacy/legislative_regulatory/wsma-legislative-report.aspx?WebsiteKey=c182ff6d-1438-4899-abc5-614681b54927&amp;_zs=B3aFd1&amp;_zl=E1IHA">2025 Legislative Report</a> (a WSMA member benefit that's currently being mailed to members), the WSMA continues to work on improving transparency and accountability in prior authorization determinations. We will continue to advocate against AI as the sole means of denying a prior authorization and continue to advocate for review by a licensed physician or health professional working within their scope of practice.
</p>
<p>
Additionally, we heard from the physician community that there are cases where a prior authorization is approved and then later denied, causing physician-led teams to chase payments from carriers. While this is already illegal under state law, we will continue our work to clarify in statute that retrospective denials shall not be considered adverse benefit determinations and will not be required to follow the standard appeal process to avoid another time-consuming hurdle for physicians and their teams.
</p>
<p>
Your voice matters to the work we do on your behalf. I urge you to continue to be in touch with us with your concerns and stories.
</p>
<p>
And as always, thank you for all you do.
</p>
</div> | 6/27/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |
| deadlines-and-delegate-opportunities-for-the-2025-annual-meeting-of-the-wsma-house-of-delegates | Deadlines and Delegate Opportunities for the 2025 Annual Meeting of the WSMA House of Delegates | Leadership | Shared_Content/News/Membership_Memo/2025/June-13/deadlines-and-delegate-opportunities-for-the-2025-annual-meeting-of-the-wsma-house-of-delegates | <div class="col-md-12">
<div class="col-sm-5 pull-right" style="text-align: center;"><img src="/images/Newsletters/MembershipMemo/2025/june/se-01-venticinque-240928-0460-2024-annual-meeting-645x425px.jpg" class="pull-right" alt="Annual Meeting session" /></div>
<h5>June 13, 2025</h5>
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<h2>Deadlines and Delegate Opportunities for the 2025 Annual Meeting of the WSMA House of Delegates </h2>
<p>Mark your calendars and plan to attend the 2025 Annual Meeting of the WSMA House of Delegates at The Westin Bellevue, Sept. 20-21. The WSMA Annual Meeting is the association's yearly policymaking event, where the voting members of the association gather to debate and determine policy, elect officers, enjoy educational offerings, and connect in person. The meeting isn't just for delegates; all are welcome to attend and take advantage of the educational offerings, social events, and networking opportunities. It's also a great way to witness firsthand how policy is made at the WSMA.</p>
<h3><strong>What you need to know in advance of the WSMA Annual Meeting </strong></h3>
<p> </p>
<p><strong>How to serve as a delegate</strong> <br />
If you would like to serve as a delegate at the 2025 Annual Meeting, please contact your local county society or state specialty society. If you are unsure who to contact, email WSMA staff at <a href="mailto:hod@wsma.org">hod@wsma.org</a>. Be sure to review the <a href="[@]wsma/about_us/who_we_are/house-of-delegates/wsma/about/who_we_are/house-of-delegates.aspx?hkey=8c843bfe-b865-4199-9765-4ac24e2de108">duties and expectations of service as a delegate</a>.</p>
<p><strong>How to propose policy<br />
</strong>As a WSMA member, you can help guide the direction of the association and raise awareness of issues of importance to the practice of medicine in Washington by authoring a resolution: a proposal asking the WSMA to take a position or act on an issue. Resolutions must be sponsored by at least two WSMA delegates. If you are interested in authoring a resolution but are not a delegate or board member, the WSMA will work with you to develop your resolution idea and find a sponsor. Contact us at <a href="mailto:hod@wsma.org">hod@wsma.org</a> for assistance. Visit the <a href="https://wsma.informz.net/z/cjUucD9taT0xMTU3ODYxMyZwPTEmdT0xMDc4MTA4MzYwJmxpPTEwOTc4Mjk2NA/index.html">How to Write a Resolution page</a> for everything you need to know about proposing policy at the WSMA Annual Meeting.</p>
<p><strong>How to review, discuss, and inform proposed policy in advance of the meeting</strong><br />
To help hone your resolution idea or to engage with other highly engaged and policy-focused WSMA members, including delegates, join our secure Virtual Reference Committees and Policy Community. Accessible using email, website, or mobile app, you may post and share resources, connect via private chat, see member profiles, and receive updates tailored to your specifications. <a href="https://wsma.informz.net/z/cjUucD9taT0xMTU3ODYxMyZwPTEmdT0xMDc4MTA4MzYwJmxpPTEwOTc4Mjk2NQ/index.html">Request to join the WSMA Virtual Reference Committees and Policy Community</a>.</p>
<p><strong>Important meeting deadlines</strong> </p>
<ul>
<li>Aug. 9: Reports and resolutions due for inclusion in delegate handbook.</li>
<li>Aug. 20: Final deadline for reports and resolutions. Resolutions received after this date must have the consent of two-thirds of the House at the opening session to be considered.</li>
<li>Aug. 28: Deadline to make room reservations at The Westin Bellevue.</li>
<li>Aug. 29: Delegate handbook will be available for download.</li>
<li>Sept. 20-21: 2025 WSMA Annual Meeting.</li>
</ul>
<p><strong>Thank you to our corporate partners</strong> </p>
<p>Thank you to our corporate partners for their generous support: Physicians Insurance, Northern Capital Management, Gohagan &amp; Company, and Resolve.</p>
</div> | 6/12/2025 12:00:00 AM | 1/1/0001 12:00:00 AM |