WashingtonSB 61032025-2026 Regular SessionSenateWALLET

Making payments for services provided by a rural emergency hospital subject to appropriation.

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Bill Overview

Analyzed Economic Effects

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

Medicaid pay at rural emergency hospitals needs funding

Payments for Medicaid services at federally designated rural emergency hospitals are subject to appropriation. The state makes these payments only if lawmakers fund them. This applies whether your Medicaid is through managed care or fee-for-service.

Higher Medicaid rates for select rural hospitals

Beginning January 1, 2015, some rural public hospitals receive 125% of their usual Medicaid fee-for-service rate. To qualify, a hospital was a sole community hospital as of January 1, 2013, had Level III adult trauma status as of January 1, 2014, had under 150 acute beds in FY 2011, and is publicly owned. These enhanced rates count as the hospital’s Medicaid rate for other programs that pay by Medicaid rates. Hospitals using the certified public expenditures program cannot get this higher inpatient rate.

Rules for rural hospital Medicaid payments

The state pays critical access hospitals based on their allowable costs each year. No new hospitals can join this payment type after July 24, 2005, except those that applied for federal certification before January 1, 2005. The state also runs a voluntary rural health access pilot that uses value-based payments for public hospital districts when money is appropriated. Goals must be set before a hospital joins, the state must explain how to exit, and transition funds last only for the expected three-year pilot. Hospitals that try the pilot can leave and return to critical access payment methods at any time.

Cap on extra Healthy Options payments

The Health Care Authority caps extra payments under Healthy Options. Any added amount per service cannot be more than the extra per-service amount paid for other Medicaid programs under this law. This limits how much more providers can be paid in Healthy Options.

Sponsors & Cosponsors

Sponsor

Ron Muzzall
Republican • Senate

Cosponsors

Annette Cleveland
Democratic • Senate
Jeff Wilson
Republican • Senate
Mark Schoesler
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 143 • No: 0

House vote • 3/4/2026

3rd Reading & Final Passage

Yes: 94 • No: 0 • Other: 4

Senate vote • 2/4/2026