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WashingtonHB 18132025-2026 Regular SessionHouse

Concerning the reprocurement of medical assistance services, including the realignment of behavioral health crisis services for medicaid enrollees.

Sponsored By: Nicole Macri (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

6 provisions identified: 4 benefits, 0 costs, 2 mixed.

Medicaid crisis patients get coordinated care

Medicaid plans and regional behavioral health organizations must use contracts to define care coordination roles and steps for crisis system users. By January 1, 2026, regional organizations must develop and use consistent electronic standards for sharing care information across regions. They must develop those standards in consultation with Medicaid plans. Plans and regional organizations must also work with the state on care strategies involving tribes and community behavioral health providers. These strategies focus on people who often use crisis services; the law sets no numeric threshold for frequent use.

Regional crisis hotlines offer round-the-clock help

Each regional behavioral health organization must run a crisis hotline 24 hours a day, every day. Hotlines must provide immediate help, assess needs, and make referrals, including connections to trained counselors and tribal crisis services. When appropriate, they must connect callers to additional services consistent with the 988 system. Regional organizations must contract with enough licensed or certified providers; the state sets that number after consulting about needed funds. Organizations and the state must develop reserve funding levels based on service use, crisis operations, and Medicaid and non-Medicaid needs. This replaces the prior reserve-or-bond requirement; the law sets no provider count or reserve amount.

Statewide planning strengthens tribal crisis coordination

Regional behavioral health organizations and their contractors must follow the crisis coordination plan agreed upon by Washington and tribes. It covers crisis care, care coordination, discharge, and transitions with tribes and Indian health care providers, including outside assigned regions. Using existing resources, the state must develop an operational plan for a statewide behavioral health organization serving American Indians and Alaska Natives. The Office of Tribal Affairs leads this work with the American Indian Health Commission and Governor's Indian Health Advisory Council. The plan must provide for coordination with tribal governments and Indian health care providers; it does not itself launch the organization.

Washington plans for Medicaid service access

Washington's Health Care Authority must consult quarterly with Commerce and Health officials to plan new or expanded regional services. Planning must consider capacity reports from plans, regional behavioral health organizations, providers, and networks, including tribal and Indian health providers. Within existing funds, preparations to select new Medicaid contractors must include regional methods to measure access for each provider type. Those methods must be used to support timely behavioral health care. Preparations must allow comments from tribes, patient groups, providers, facilities, counties, and regional behavioral health organizations, as procurement standards allow. They must also offer opportunities to change plan contracts to reduce providers' paperwork. The law has no operative effect unless the omnibus budget provides funding specifically identifying this act by June 30, 2025.

Medicaid crisis care gets regional oversight

By July 1, 2026, Washington must require Medicaid plans to establish, continue, or expand crisis care arrangements with regional behavioral health organizations. Services include phone help, mobile crisis teams, peer support, and crisis stabilization services and facilities. Plans must contract with the state-selected regional organization, reimburse care for their members, and negotiate payment for medical services at crisis facilities. These arrangements must meet standards tied to required health plan accreditation and undergo audits; the state may provide technical help. Facility-based arrangements may end when standards remain unmet after that help. Plans must report audit findings and corrective actions to the state within 72 hours.

Medicaid rates track regional service changes

Washington must direct its rate-setting contractor to adjust Medicaid managed care rates when regional programs or facilities open, expand, close, or shrink. Increases for new or expanded services must be made promptly, before opening or expansion, consistent with rate-setting cycles. Managed care and fee-for-service rates must be adjusted in the rate-setting cycle after a closure or service reduction. The law sets no dollar amount or formula for these changes.

Sponsors & Cosponsors

Sponsor

  • Nicole Macri

    Democratic • House

Cosponsors

  • Beth Doglio

    Democratic • House

  • Gerry Pollet

    Democratic • House

  • Lauren Davis

    Democratic • House

  • Lisa Parshley

    Democratic • House

  • Shaun Scott

    Democratic • House

  • Timm Ormsby

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 171 • No: 70

House vote • 4/21/2025

Final Passage as Amended by the Senate

Yes: 62 • No: 35 • Other: 1

Senate vote • 4/16/2025

3rd Reading & Final Passage as Amended by the Senate

Yes: 30 • No: 19

House vote • 3/11/2025

3rd Reading & Final Passage

Yes: 79 • No: 16 • Other: 3

Actions Timeline

  1. Effective date 7/27/2025.

    5/12/2025House

  2. Chapter 216, 2025 Laws.

    5/12/2025House

  3. Governor signed.

    5/12/2025legislature

  4. Delivered to Governor.

    4/24/2025legislature

  5. President signed.

    4/23/2025legislature

  6. Speaker signed.

    4/22/2025legislature

  7. Passed final passage; yeas, 62; nays, 35; absent, 0; excused, 1.

    4/21/2025House

  8. House concurred in Senate amendments.

    4/21/2025House

  9. Third reading, passed; yeas, 30; nays, 19; absent, 0; excused, 0.

    4/16/2025House

  10. Rules suspended. Placed on Third Reading.

    4/16/2025House

  11. Committee amendment(s) adopted with no other amendments.

    4/16/2025House

  12. Placed on second reading by Rules Committee.

    4/15/2025House

  13. Minority; without recommendation.

    4/8/2025House

  14. Minority; do not pass.

    4/8/2025House

  15. WM - Majority; do pass with amendment(s).

    4/8/2025House

  16. Passed to Rules Committee for second reading.

    4/8/2025House

  17. Referred to Ways & Means.

    3/29/2025House

  18. And refer to Ways & Means.

    3/27/2025House

  19. Minority; do not pass.

    3/27/2025House

  20. HLTC - Majority; do pass with amendment(s).

    3/27/2025House

  21. First reading, referred to Health & Long-Term Care.

    3/14/2025House

  22. Third reading, passed; yeas, 79; nays, 16; absent, 0; excused, 3.

    3/11/2025House

  23. Rules suspended. Placed on Third Reading.

    3/11/2025House

  24. Floor amendment(s) adopted.

    3/11/2025House

  25. 2nd substitute bill substituted.

    3/11/2025House

Bill Text

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