AN ACT Relating to requiring entities offering medicare advantage coverage in Washington to provide certain disclosures to consumers;
Summary
HB 1639 requires entities offering Medicare Advantage coverage in Washington to provide specified disclosures to enrollees and prospective enrollees. Before enrollment, and again upon request after enrollment, the entity must disclose its claimed denial rate expressed as a percentage, the percentage of denied claims that were granted on appeal, and the process by which an enrollee may appeal a denial of coverage.
The bill also declares that these practices are matters of vital public interest and places violations of the new chapter within Washington’s Consumer Protection Act framework. In effect, a violation is deemed an unfair or deceptive act in trade or commerce and an unfair method of competition, creating potential consumer-protection liability for noncompliance. The bill adds a new chapter to Title 48 RCW, which governs insurance.
Impact
HB 1639 would impose new disclosure obligations on Medicare Advantage carriers and other entities offering that coverage in Washington, requiring them to provide standardized information about denial rates and appeals. It would also expand the legal consequences of failing to comply by making violations actionable under the Consumer Protection Act, which can increase enforcement exposure and potentially support private or public consumer-protection claims. The bill primarily affects insurers, Medicare Advantage plans, and Washington consumers shopping for or enrolled in those plans.
Sentiment
Based on the bill text and the absence of recorded committee discussion or votes in the provided materials, the overall sentiment appears consumer-protective and transparency-oriented. The measure is framed as improving public access to information needed to compare Medicare Advantage offerings and understand how coverage denials are handled. No opposing viewpoints are documented in the supplied record, but the structure of the bill suggests it may be viewed as increasing regulatory obligations on insurers.
Contention
The main point of contention likely concerns the burden on Medicare Advantage providers versus the consumer benefit of greater transparency. Insurers may object to mandatory publication of denial-rate and appeal-success information, especially if they believe the metrics could be misleading or administratively difficult to compile consistently. Consumer advocates would likely support the bill because it gives enrollees clearer information about coverage denials and appeal rights before they choose a plan.
Requiring guaranteed issue of medicare supplemental coverage to an individual who voluntarily disenrolls from a medicare advantage plan and enrolls in medicare parts A and B.