The bill aims to enhance patient access to timely and medically necessary postacute care services by establishing network adequacy standards for nursing homes and inpatient rehabilitation facilities within managed care contracts for medical assistance programs. A new section is added to chapter 74.09 RCW, mandating the authority to develop and adopt these standards by January 1, 2028. The standards will consider factors such as provider availability, timeliness of care, and compliance with federal Medicaid regulations. Stakeholder feedback from hospitals, nursing homes, and managed care organizations will be sought during the development process to ensure comprehensive input.

Additionally, the bill amends RCW 74.09.522 to require that managed care organization contracts effective on or after July 1, 2028, meet the established network adequacy requirements for postacute care services. This includes nursing homes and inpatient rehabilitation facilities, as well as any other necessary postacute care services determined by the authority. The adequacy requirements will be integrated into existing monitoring and reporting frameworks to ensure compliance and improve access to care for Medicaid enrollees.

Statutes affected:
Original Bill: 74.09.522
Substitute Bill: 74.09.522
Engrossed substitute: 74.09.522
Bill as passed Legislature: 74.09.522
Session law: 74.09.522