The bill adds a new section to chapter 74.09 RCW that requires coverage, without prior authorization or step therapy, for all U.S. Food and Drug Administration–approved HIV antiviral drugs for Apple Health clients enrolled in both fee‑for‑service and managed care programs. It also requires that, upon initiation or renewal of a contract with "the authority" to administer a Medicaid managed care plan, a managed health care system provide the same no‑prior‑authorization, no‑step‑therapy coverage for all FDA‑approved HIV antiviral drugs. This is a new statutory coverage mandate (a procedural change to benefits administration) rather than a criminal or penalty provision. The bill designates the act as necessary for the immediate preservation of public peace, health, or safety and takes effect July 1, 2025. The bill passed the Senate on February 28, 2025 (48-0) and the House on March 27, 2025 (94-0). The provided text does not define key terms used in the new section—such as "the authority," "Apple Health clients," or "managed health care system"—nor does it include detailed implementation, enforcement, exceptions, the exact new section number, or transition provisions.

If enacted, Medicaid members in Washington (referred to in the bill as "apple health clients") would be able to get any FDA‑approved HIV antiviral drug without having to obtain prior authorization or go through step‑therapy protocols, both in fee‑for‑service and in managed care. That change is likely to speed access to HIV medications and reduce administrative delays or denials for patients, but it will probably increase drug spending pressure on the Medicaid program and on managed care plans that must follow the rule when they start or renew contracts to run Medicaid plans. The bill names an entity called "the authority" to enforce the requirement but does not define that term in the provided text, and it does not include details on funding, exceptions, or how existing contracts are handled beyond the contract initiation/renewal trigger; those missing details create uncertainty about implementation and who ultimately bears any added costs. The law would take effect July 1, 2025.