HB 1674
In CommitteeHouse
Hepatitis B & C screening
Concerning hepatitis B and hepatitis C screening.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill requires primary care providers in Washington to offer hepatitis B and C screening tests to adult patients during routine visits, with follow-up care for positive results. It also mandates provider training and allows the Department of Health to adopt rules for implementation, but does not impose penalties for noncompliance.
- Primary care providers must offer hepatitis B and C screening tests during annual exams, wellness visits, or first-time visits with adult patients, based on CDC-recommended criteria.
- Health care entities may comply by offering tests directly, using prompts in electronic health records, or mailing/emailing information to eligible patients.
- Exceptions apply if the patient is in a life-threatening emergency, has already been screened (unless retesting is clinically indicated), or lacks capacity to consent.
- Positive screening results require follow-up care or referral—including a hepatitis C diagnostic test for those with a positive hepatitis C screen.
- All primary care providers must complete online hepatitis education training by January 1, 2026 (or before starting practice if licensed or new to primary care after that date).
- The bill explicitly states that noncompliance does not result in licensure actions, civil liability, or criminal penalties.
Who is affected
- Adult patients receiving primary care — Adult patients receiving primary care services (e.g., annual checkups or first visits with a new provider) will be offered hepatitis B and C screening tests as part of routine care, unless specific exceptions apply.
- Health care entities providing primary care — Clinics, urgent care centers, and other settings providing primary care must implement systems to offer hepatitis screening tests and ensure follow-up care for positive results.
- Health care providers delivering primary care — Providers must complete hepatitis education training and ensure culturally and linguistically appropriate screening and follow-up services.
- Patients who test positive for hepatitis B or C — Patients who test positive for hepatitis B or C will be offered or referred for follow-up diagnostic testing and treatment.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Routine hepatitis B and C screening during primary care visits will increase early detection—especially for asymptomatic individuals—leading to timely treatment, reduced liver disease progression, and lower long-term healthcare costs.
HealthcarePeopleRef: Sec. 1(1), (3)(b)Mandating follow-up care—including hepatitis C diagnostic testing for positive screens—ensures linkage to curative treatment (e.g., antivirals), directly improving health outcomes for low-income and underserved patients who might otherwise face access barriers.
HealthcarePeopleRef: Sec. 1(3)(b), (9)(a)Culturally and linguistically appropriate screening and mandatory provider training will improve trust and communication, particularly for immigrant communities disproportionately affected by hepatitis B and C.
HealthcarePeopleRef: Sec. 1(4), (5)Expanding routine screening to include first-time visits with new providers helps identify undiagnosed cases in populations not regularly accessing care—reducing transmission risk and supporting public health surveillance.
Public SafetyPeopleRef: Sec. 1(1)The definition of 'health care entity where primary care services are provided' includes unlicensed clinics and urgent care centers, broadening access to screening beyond traditional medical homes—benefiting marginalized populations who rely on safety-net clinics.
HealthcareLean peopleRef: Sec. 1(9)(b)
Potential Concerns (5)
The bill explicitly bars civil, criminal, or licensure penalties for noncompliance, which may weaken enforcement and reduce provider accountability, potentially undermining the reliability of screening and follow-up care.
Public SafetyRef: Sec. 1(7)Providers must complete hepatitis education training by a fixed deadline, which may impose time and administrative burdens on small clinics and solo practitioners without dedicated training staff or paid time, potentially disrupting clinical workflows.
Business & EmploymentLean peopleRef: Sec. 1(5)Allowing mailers or emails as a compliance method may reduce direct screening uptake among patients with limited digital access, language barriers, or low health literacy—particularly older, rural, or low-income patients.
HealthcareRef: Sec. 1(1)(c)The exception for prior screening may lead to missed opportunities for retesting in high-risk populations (e.g., people who inject drugs, immigrants from endemic regions) if providers do not assess retesting need, potentially delaying diagnosis.
HealthcareLean peopleRef: Sec. 1(2)(b)The bill lacks a fiscal impact estimate and provides no dedicated funding for training, testing, or follow-up care, potentially shifting costs to providers and public health departments without reimbursement mechanisms.
Local GovernmentRef: Fiscal Impact section (not in bill text)
Who Is Most Affected
Adult patients, especially those from high-prevalence groups (e.g., Baby Boomers, immigrants from endemic regions, people who inject drugs), gain early access to life-saving screening and treatment. Low-income and uninsured patients benefit most if follow-up care is covered by Medicaid or charity care.
Small clinics and safety-net providers may face administrative burdens (e.g., training, EHR updates), but also gain improved patient outcomes and potential reimbursement for follow-up care. Large health systems may absorb costs more easily, while under-resourced clinics may struggle without state support.
Providers gain clinical knowledge and tools to manage hepatitis, but must invest time in training. Providers in under-resourced areas may face challenges in offering timely follow-up due to specialist shortages.
Patients who test positive gain access to curative hepatitis C treatment and chronic hepatitis B management—reducing liver cancer and cirrhosis risk. However, without guaranteed insurance coverage or sliding-scale fees, out-of-pocket costs for diagnostics/treatment may still be prohibitive.