The bill (House Bill 1639, H-0859.1, 69th Legislature, 2025 Regular Session) would require entities offering Medicare Advantage coverage to Washington residents to disclose to enrollees and potential enrollees the entity’s claims denial rate (as a percentage), the percentage of denied claims that are granted on appeal, and the process an enrollee may use to appeal a denial. Those disclosures must be provided before enrollment and made available upon request after enrollment. The act adds two sections as a new chapter in Title 19 RCW and declares violations of the new chapter to be unfair or deceptive acts under the Washington Consumer Protection Act (chapter 19.86 RCW). This is a procedural disclosure requirement and a statutory classification of violations as consumer protection violations; it does not, in the provided text, create a new criminal offense or specify penalties, enforcement authority, calculation methodology, format or timing beyond “prior to enrollment” and “upon request,” or how the rule interacts with federal Medicare/CMS requirements or state insurance regulators. The bill was read for the first time on 01/28/25 and referred to the Committee on Health Care & Wellness.

If enacted, companies that offer Medicare Advantage plans to Washington residents would have to provide prospective and enrolled members with three pieces of information: the plan’s overall claims denial rate as a percentage, the percentage of those denials that were reversed on appeal, and the steps an enrollee must take to appeal a denial. This will give consumers more data to compare plans and could change enrollment choices; it will also require plans to collect, calculate, and distribute those metrics and to train staff to respond to disclosure requests, creating added administrative work and likely modest compliance costs. Because the bill treats violations as unfair or deceptive acts under Washington’s consumer protection law, plans that fail to disclose could face consumer protection actions, increasing legal risk. Key details needed for firms to comply are missing from the text provided: there are no definitions or methods for calculating the rates, no required format, timing, or delivery method for disclosures, no specified enforcement agency or penalties, no effective date, and no discussion of how these requirements interact with federal Medicare rules. Those gaps make the practical compliance burden and legal exposure uncertain until the bill is clarified or implementing guidance is issued.