Lori Grassi WSCA Executive of Legislation and Policy


The 2026 legislative session adjourned sine die on Thursday, March 12, closing out a fast-paced and, at times, challenging 60-day session. While I tracked a number of bills this year, I will focus here on those most relevant to chiropractic.


To begin, it is helpful to understand the current political landscape in Washington. Democrats hold the majority in both chambers— by 11 votes in the Senate and 20 votes in the House. As is typical, the majority party controls committee leadership and largely determines which bills advance through the process. That said, much of our work remains bipartisan. Even so, political dynamics can—and do—impact outcomes. This session, one of our priority bills became a casualty of that reality.


SB 5899 – Animal Chiropractic SB 5899 proposed creating a license endorsement to allow qualified chiropractors to diagnose and adjust nonhuman animals. Sponsored by Senator Shelly Short (R-7) and co-sponsored by Senator Marko Liias (D-21), this bill represented a significant step forward for the profession offering chiropractors another income source not related to an insurance carrier.


We worked diligently with the Washington State Veterinary Medical Association to reach a neutral position, allowing the bill to move forward during the compressed session. The effort paid off—the bill advanced out of committee, reached the Senate floor, and passed unanimously with a 49–0 vote.


However, on the House of Origin cutoff day, broader political maneuvering between the chambers resulted in several bills being halted, including SB 5899. While disappointing, this is not uncommon in the legislative process. We will return next year with renewed focus. In the meantime, it is important for members to engage with their legislators and emphasize the importance of this issue.


SB 5395 – Prior Authorization Reform SB 5395 addresses ongoing concerns with prior authorization—a process that continues to evolve, particularly with the increasing use of artificial intelligence.


This legislation improves transparency and accountability in several key ways: • Provider Transparency: Health plans must now disclose the credentials, certifications, and specialties of the professionals overseeing prior authorization decisions.


• Policy Visibility: Carriers must post all prior authorization policies and updates in a single, accessible location.


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• AI Oversight: Most notably, the bill establishes clear guardrails for artificial intelligence:


– Only a licensed provider may determine medical necessity. – AI may assist in processing or approving requests but cannot independently deny, delay, or modify care.


– Decisions must consider the individual patient’s clinical history and circumstances—not solely group data.


– AI systems must comply with state and federal law, avoid discriminatory outcomes, and remain subject to audit by the Office of the Insurance Commissioner.


– Data use must remain limited to its intended purpose.


• Protection Against Retrospective Denials: Carriers may not retroactively deny or downgrade care that was previously authorized, except in cases of material misrepresentation or coverage termination. If an authorization is deemed valid, it must be paid—with interest accruing at 1% per month if delayed.


This is a meaningful step forward as healthcare increasingly incorporates advanced technologies into decision-making.


SB 5845 – Claims Processing and Payment Standards SB 5845 introduces clearer timelines and accountability for claims processing:


• Clean Claims: Must be paid or denied within 30 days. • Incomplete Claims: Within 21 days, carriers must notify providers of denial or request all necessary information in a single, good-faith effort.


• Final Determination: Once requested information is received, carriers must pay or deny the claim within 30 days.


The bill also establishes financial consequences for delays: • 1% monthly interest for claims unresolved within 60 days • 1.5% monthly interest for claims unresolved between 61–89 days


• Additional penalties may apply beyond 90 days, as determined by the Insurance Commissioner


Importantly, this law also tightens timelines for overpayment recovery beginning January 1, 2028: • Standard recovery window reduced from 24 months to 12 months


• Coordination of benefits cases limited to 18 months


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