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WashingtonSB 59232025-2026 Regular SessionSenateWALLET

Concerning critical access hospital designations in Skagit county.

Sponsored By: Ron Muzzall (Republican)

Became Law

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 1 benefits, 0 costs, 2 mixed.

Voluntary Skagit pilot for rural hospital payments

The state runs a pilot in Skagit County to keep rural hospital services. Joining is optional. Before any hospital joins, state health agencies and the hospital association set clear goals. Before joining, the Health Care Authority explains how a hospital can leave. If a hospital approved for critical access payments joins and stops those payments, it can return to that payment method at any time. For Medicaid patients, public health care districts in the pilot use a value-based payment method set by the Health Care Authority. Subject to funding, payments support emergency and primary care and adjust for quality and value. The Authority also encourages other payers to use this method. Transition funds only help hospitals move to the new method and end after the planned three-year pilot.

Critical access hospital pay rules and limits

The law pays rural critical access hospitals based on their yearly allowable costs. This applies even if the patient is in Medicaid managed care. It does not apply to hospitals that join the rural health pilot. A moratorium began July 24, 2005, so new hospitals cannot newly enter this payment program. Hospitals that applied for federal critical access status before January 1, 2005 still qualify. A hospital on an island in a Skagit County public hospital district that is federally certified as a critical access hospital is eligible for these payments.

Higher Medicaid rates for select rural hospitals

Beginning January 1, 2015, some rural hospitals get 125% of their Medicaid fee-for-service rates. To qualify, the hospital had sole community hospital status by January 1, 2013; a level III adult trauma designation by January 1, 2014; fewer than 150 acute care beds in fiscal year 2011; and public ownership. Other payers that follow Medicaid rates must use this higher rate for these hospitals. Hospitals in the certified public expenditures program cannot get the 125% inpatient rate.

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Sponsors & Cosponsors

Sponsor

  • Ron Muzzall

    Republican • Senate

Cosponsors

  • Liz Lovelett

    Democratic • Senate

  • Sharon Shewmake

    Democratic • Senate

  • T'wina Nobles

    Democratic • Senate

Roll Call Votes

All Roll Calls

Yes: 145 • No: 0

House vote • 3/4/2026

3rd Reading & Final Passage

Yes: 96 • No: 0 • Other: 2

Senate vote • 2/16/2026

3rd Reading & Final Passage

Yes: 49 • No: 0

Actions Timeline

  1. Effective date 6/11/2026.

    3/17/2026Senate

  2. Chapter 84, 2026 Laws.

    3/17/2026Senate

  3. Governor signed.

    3/17/2026legislature

  4. Delivered to Governor.

    3/9/2026legislature

  5. Speaker signed.

    3/5/2026legislature

  6. President signed.

    3/5/2026legislature

  7. Third reading, passed; yeas, 96; nays, 0; absent, 0; excused, 2.

    3/4/2026Senate

  8. Rules suspended. Placed on Third Reading.

    3/4/2026Senate

  9. Rules Committee relieved of further consideration. Placed on second reading.

    3/3/2026Senate

  10. Referred to Rules 2 Review.

    3/2/2026Senate

  11. APP - Executive action taken by committee.

    2/27/2026Senate

  12. APP - Majority; do pass.

    2/27/2026Senate

  13. Referred to Appropriations.

    2/17/2026Senate

  14. Committee relieved of further consideration.

    2/17/2026Senate

  15. First reading, referred to Health Care & Wellness.

    2/17/2026Senate

  16. Third reading, passed; yeas, 49; nays, 0; absent, 0; excused, 0.

    2/16/2026Senate

  17. Rules suspended. Placed on Third Reading.

    2/16/2026Senate

  18. 1st substitute bill substituted.

    2/16/2026Senate

  19. Placed on second reading by Rules Committee.

    2/10/2026Senate

  20. Passed to Rules Committee for second reading.

    2/6/2026Senate

  21. WM - Majority; 1st substitute bill be substituted, do pass.

    2/5/2026Senate

  22. First reading, referred to Ways & Means.

    1/12/2026Senate

  23. Prefiled for introduction.

    12/22/2025Senate

Bill Text

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