Ron Muzzall — Senator Ron Muzzall introduced the bill as a follow-up to prior legislation addressing difficult-to-discharge patients, explaining that it creates a pre-approved pathway for handling those cases and then concluding his remarks.
Katie Colan — Katie Colan testified in strong support of Senate Bill 5124, explaining that patients need timely and predictable access to post-acute care and that delays keep patients in hospitals longer and increase costs. She described how single-case agreements are used today to manage these transfers and urged the committee to move the bill out of committee.
Dina — The chair indicated Dina would testify after Katie.
SB5124 — Public testimony on Senate Bill 5124 was presented in support of the bill. The witness explained that the problem the bill addresses still persists and that the measure would help address one part of the lengthy process of moving patients through the care continuum, including discharge and placement delays. The segment concluded with the closing of public testimony on the bill.
Dina Hannon — Dina Hannon, vice president of case management and chief nursing executive for ambulatory nursing at MultiCare Health System, testified in support of SB 5124. She explained that the lack of network adequacy standards for post-acute care in Medicaid MCOs creates major barriers to moving patients through the care continuum. Because hospitals must find accepting SNFs or rehab facilities and then secure insurer approval, discharge planning can take multiple days. When insurers do not have contracts with the accepting facility, a single-case agreement is required, which further delays discharge and can force patients to go to facilities outside their community. She said these problems contribute to backlogs of patients waiting in hospital beds and the ED, and concluded that the bill would help address one part of this lengthy process.
SB5594 — The committee returned to SB 5594 and heard continued support for the bill. Speakers described it as allowing pharmacists to proactively substitute interchangeable or therapeutically equivalent biosimilars when appropriate, emphasized that biosimilars are safe FDA-approved alternatives to high-cost biologics, and argued the bill would help Washington consumers access lower-cost options at the pharmacy counter without requiring new state funding. The bill was also presented as a workable policy already used in many other states.
Marissa Ingalls — Marissa Ingalls was called to testify on SB 5594 and spoke in strong support on behalf of the Association of Washington Health Care Plans. She said the bill would reduce costs and align Washington with other states, and noted that the language had already been carefully negotiated with interested parties. She also explained that automatic substitution already works in other states, reinforcing support for the measure.
Chris Bandley — Chris Bandley, speaking for America's Health Insurance Plans, testified in strong support of SB 5594. He argued that Washington should continue encouraging the use of lower-cost prescription drugs because drug spending is rising, and said the bill would help move patients to safe FDA-approved biosimilars and interchangeable biologics that can save consumers money. He acknowledged there may still be some stakeholder concerns, but urged the committee to work through them and advance the bill.
SB5594 — Public testimony on Senate Bill 5594 is presented as a continuous discussion of the bill’s biosimilar substitution provisions. The witness expresses strong support for the bill, explains its intent and notes a language change from the prior year, raises concerns about how it would function in practice at the pharmacy counter, and suggests structural revisions to the bill’s sections—particularly around where biosimilars should be placed and how Section 2 could improve utilization. The testimony concludes with the close of public comment on the bill.
Aaron Jajik — Testified on behalf of the Patient Coalition of Washington, raising implementation concerns rather than opposition to the bill's goal.
pharmacists — The speaker says pharmacists were not present and describes their role in substitution and cost-sharing processing.
Matt Marshall — Representative Matt Marshall discusses whether the bill could be structured similarly to generic substitution rules, including dispense-as-written options, and whether a comparable approach would address the concerns raised. He emphasizes that the issue is not with pharmacists or patients, but with ensuring patients do not face higher cost-sharing when switching to biosimilars. He suggests using formulary placement as a preferred option to keep costs lower and asks for proposed language, offering to email suggested formulary wording.
Brett Michelin — Brett Michelin of the Association for Accessible Medicines testifies in support of the bill, with a suggested amendment to the section structure. He argues that biosimilars are safe and effective, have already generated substantial savings, but still have too little market share because of market practices that suppress utilization. He recommends adding biosimilars back into Section 1A and placing them in a preferred tier with insurers and PBMs to improve patient access, while noting they should be preferred but not treated as identical across all products.
Joe Schmick — Representative Joe Schmick, identified as the ranking member, was addressed in the opening remarks and then called on for a clarification question.
Paul Harris — Senator Paul Harris was invited to speak about the bill and then continued by advocating for it, drawing on personal experience with cancer and arthritis and noting that it could help provide lower-cost alternatives.
SB5142 — Engrossed Senate Bill 5142 was introduced in staff report as a bill addressing Medicaid network adequacy for post-acute care services, and the sponsor later described it as a follow-up bill to prior legislation.
Chris Blake — Committee staff presented the staff report on ESSB 5142.
SB5594 — The staff introduced Engrossed Second Substitute Senate Bill 5594 as a bill relating to biosimilars and explained that it expands existing substitution and utilization provisions to include all biosimilars. The discussion also noted that the bill removes the requirement that every prescription specify whether substitution is allowed, clarifying the pharmacist substitution rules.
Kim Weidener — Committee staff presented the staff report on ESSB 5594.