This bill adds new requirements to Washington law making health carriers and Medicaid managed care organizations cover medically necessary anesthesia services for any procedure covered by the health plan regardless of how long anesthesia care lasts. Carriers are prohibited from denying payment or imposing time-based caps on anesthesia reimbursement; payment must be determined solely on medical necessity as assessed by the physician or certified registered nurse anesthetist (CRNA). All anesthesia claims must include the provider’s national provider identifier (NPI). For plans issued on or after January 1, 2026, and for Medicaid/authority plans beginning January 1, 2026, carriers may not treat physicians and CRNAs differently on verification of competency, billing codes/modifiers, coverage, compensation, or reimbursement when the provider is acting within their scope of licensure and certification, and carriers may not reduce payments to comply with the nondiscrimination requirement. The bill creates new statutory sections (amending and reenacting related provisions, including RCW 41.05.017) and gives the insurance commissioner enforcement authority in addition to existing law. The commissioner may adopt rules to implement the sections, impose civil monetary penalties (to be set by rule), require reimbursement for improperly denied claims, require restitution and compensatory payments to affected providers and enrollees, suspend or revoke a carrier’s license for repeated or egregious violations, and publicly disclose violations. Individuals and providers may file complaints with the insurance commissioner or pursue other state-law remedies. The act includes an emergency clause and takes effect immediately, with specified nondiscrimination provisions effective January 1, 2026. The text supplied does not assign specific RCW section numbers to the new sections added to chapter 48.43 RCW or chapter 74.09 RCW, does not define the term “authority” within this excerpt, and does not state specific civil penalty amounts, rulemaking deadlines, or the standards and procedures the commissioner will use to determine restitution or public disclosures.

If enacted, private insurers and Medicaid managed care plans would no longer be allowed to deny or cap payment for anesthesia simply because anesthesia care lasted longer than an arbitrary time limit; payment must be based on whether a physician or certified registered nurse anesthetist (CRNA) says the time was medically necessary. Claims will need the provider NPI, and for plans issued on or after January 1, 2026 (and for Medicaid/authority plans beginning that date) carriers must treat physicians and CRNAs the same on verification, billing, and reimbursement when they are working within their license. The insurance commissioner can force restitution, levy civil penalties, suspend or revoke licenses, and publish violations, and must adopt rules to implement the changes. The groups most affected are health carriers and Medicaid managed care organizations, which will likely face higher payment obligations, changes to claims procedures, and greater regulatory risk and potential public exposure if they continue prior time-based limits; they also may not offset nondiscrimination by reducing provider pay. Anesthesia providers (physicians and CRNAs) and patients will likely see fewer time-based denials and more consistent payment when care is judged necessary. Important details are left unclear in the text provided—such as exact penalty amounts, the administrative rule timeline, and the precise meaning of “authority”—so how and when enforcement will play out in practice is uncertain.