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Evergreen Ledger

SHB 1076

In Committee

House

Health technology assessment

Concerning the health technology assessment program.

This status may be delayed. See Action History below for the latest updates.

How does a bill become law?
  1. Introduced: The bill is filed and assigned a number.
  2. Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
  3. Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
  4. Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
  5. Governor: The Governor reviews the bill and decides whether to sign or veto it.
  6. Signed: The bill has been signed into law.
Introduced: January 30, 2025
Last Action: January 12, 2026
Status: H HC/Wellness
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AI Analysis

This analysis was generated by AI and may contain errors. It is not legal advice. Always refer to the official bill text for authoritative information.
People & CommunitiesPeople-leaningCorporate & Wealthy Interests

This bill updates Washington’s Health Technology Assessment Program to improve how the state evaluates new medical technologies before deciding whether to cover them in state health programs. It strengthens evidence review standards, adds transparency and public input, and prioritizes technologies used in Medicare or for rare/life-threatening conditions. It also sets deadlines for decisions and requires regular re-evaluation of covered technologies.

  • The state will review up to six health technologies in the first year and up to eight in the second year after the bill takes effect, prioritizing technologies used in Medicare, recommended in national guidelines, or with high state costs or safety concerns.
  • Selected technologies will be re-reviewed at least every 18 months if new evidence emerges that could change prior decisions.
  • The review process must include systematic, evidence-based assessments conducted by federally designated centers, incorporating data from state agencies and public submissions.
  • Assessments must prioritize the most reliable evidence and consider how technologies affect specific populations (e.g., by sex, race, age, or disability).
  • For life-threatening or rare diseases, the committee must consider all available clinical trials—including those not using randomized designs—if randomized trials are unethical or impractical.
  • The committee must issue coverage decisions (including conditions for use and medical necessity criteria) within 180 days of submission, and provide written explanations for adverse decisions.
  • Public comment and transparency are required, and the committee may form temporary expert advisory groups with liability protections.

Who is affected

  • State health programs (e.g., Medicaid, Apple Health) — State-run health programs (like Medicaid) may adjust coverage decisions based on the committee's findings, potentially limiting or expanding access to certain technologies.
  • Patients with life-threatening or rare diseases — Patients with life-threatening or rare conditions may gain or lose access to new treatments depending on whether the technology is deemed safe, effective, and cost-effective for their group.
  • Healthcare providers and facilities — Hospitals, clinics, and providers may need to adjust how they use or bill for certain technologies based on coverage rules set by the state.
  • Medical technology and drug manufacturers — Manufacturers or developers of medical devices, drugs, or diagnostics may be required to submit evidence or respond to public petitions about their products.
  • Patients, caregivers, advocacy groups, and insurers — Patients, caregivers, advocacy groups, and insurers can submit evidence or comments during the review process and may be affected by final coverage decisions.
Effective: July 28, 2025Fiscal impact: The bill requires contracts for systematic assessments of health technologies, which may increase state spending on evidence review, but could also lead to long-term savings by reducing use of low-value or high-cost technologies in state health programs.
Model: Intel/Qwen3-Coder-Next-int4-AutoRoundGenerated: Mar 20, 2026 at 2:04 AM

Pro/Con Analysis

Stronger case for benefits

Potential Benefits (5)

  • Mandating public comment, transparency, and use of federally designated evidence centers improves legitimacy and reduces industry capture in coverage decisions—empowering patients, advocates, and clinicians to influence policy rather than leaving decisions to opaque administrative processes.

    HealthcarePeopleRef: Sec. 1(1)(a)

  • Allowing non-randomized evidence for life-threatening or rare diseases (e.g., case series, registries) when RCTs are unethical or impractical expands access to promising therapies for patients with few alternatives—particularly critical for ultra-rare conditions where RCTs are infeasible.

    HealthcarePeopleRef: Sec. 1(5)(b)

  • Requiring medical necessity criteria and conditions of use for covered technologies helps prevent overuse of low-value or high-cost interventions, promoting more appropriate, efficient care—potentially lowering premiums and out-of-pocket costs for enrollees in state health programs.

    HealthcarePeopleRef: Sec. 2(1)(b)

  • Mandatory 18-month rereview ensures coverage decisions remain current with evolving evidence, reducing the risk of permanently covering ineffective or harmful technologies—benefiting long-term patient safety and program sustainability.

    HealthcareLean peopleRef: Sec. 1(2)

  • Contracting assessments to federally designated evidence-based practice centers (e.g., AHRQ-funded centers) raises methodological rigor and reduces bias—improving reliability of coverage decisions for all stakeholders.

    Public SafetyRef: Sec. 1(4)(a)
Potential Concerns (5)

  • The bill’s requirement that technologies be selected only if there is “adequate evidence available to conduct the complete review” may delay or block access to novel, high-need technologies—especially for rare or life-threatening conditions—where evidence is inherently limited or emerging, even if clinical need is urgent. This could disproportionately affect patients with rare diseases who rely on off-label or compassionate-use technologies not yet meeting rigid evidence thresholds.

    HealthcarePeopleRef: Sec. 1(1)(b)(ii)-(iii)

  • Prioritizing technologies already covered under Medicare or recommended in national guidelines may reinforce existing inequities, as Medicare coverage and guideline adoption often lag behind innovations and may reflect biases in clinical trial populations (e.g., underrepresentation of racial/ethnic minorities, women, or older adults), limiting access for historically underserved groups in Washington’s Medicaid program.

    HealthcarePeopleRef: Sec. 1(1)(a)

  • The 180-day decision deadline for coverage determinations improves timeliness and accountability, reducing arbitrary delays in coverage decisions for patients and providers. However, this may increase pressure on assessment centers and could risk rushed or superficial reviews if staffing or resources are insufficient—potentially compromising decision quality.

    Public SafetyRef: Sec. 2(4)

  • Mandating consideration of differential impacts by sex, race, age, or disability improves equity in technology assessment, but the bill provides no new funding or methodological guidance on how to operationalize this requirement—limiting its practical effect without additional support.

    HealthcareRef: Sec. 1(4)(d)(ii)

  • Requiring consistency with Medicare and national guidelines unless “substantial evidence” supports deviation may entrench conservative coverage policies, discouraging adoption of innovations that differ from mainstream practice—even when local evidence (e.g., from Washington’s Medicaid population) suggests superior outcomes or cost-effectiveness.

    HealthcareRef: Sec. 2(3)

Who Is Most Affected

State health program enrollees (e.g., Medicaid/Apple Health)Mixed Impact

Medicaid/Apple Health enrollees—especially those with rare or life-threatening conditions—may gain faster access to high-need technologies that meet evidence thresholds, but could be excluded from novel therapies if evidence standards are too rigid. Overall, this group benefits from increased transparency and equity considerations, but faces potential access barriers for cutting-edge treatments.

Patients with rare or life-threatening diseasesPositive Impact

Patients with rare or life-threatening diseases benefit significantly from provisions allowing non-randomized evidence and expedited review, but may be harmed if technologies are excluded due to lack of RCT data—despite clinical need. This group is likely to be net positive given the bill’s emphasis on flexibility for rare conditions.

Healthcare providers and facilitiesMixed Impact

Hospitals and clinics may benefit from clearer coverage criteria and reduced administrative uncertainty, but could face operational challenges in adapting to new medical necessity requirements or delayed coverage for certain technologies. Providers in safety-net settings may be disproportionately affected by coverage limitations.

Medical technology and drug manufacturersNegative Impact

Medical technology manufacturers may face higher evidence burdens and longer time-to-coverage, especially for novel or rare-disease technologies. While transparency and public input improve fairness, the process may increase time and cost to market for Washington’s state programs—disproportionately affecting small innovators with limited resources.

Patients, caregivers, advocacy groups, and insurersMixed Impact

Patients, caregivers, and advocacy groups gain formal avenues to submit evidence and influence decisions—a meaningful empowerment. However, those without resources to mount formal petitions or engage in technical comment processes (e.g., rare disease advocates with limited data infrastructure) may be marginalized despite procedural openness.