The bill amends RCW 74.09.520 to enhance payment provisions for acute care hospitals regarding Medicaid patients who are difficult to discharge. It establishes that hospitals will be compensated for days when patients, enrolled in medical assistance, do not meet the criteria for acute inpatient care but are unable to be discharged due to a lack of available placement in appropriate facilities, such as nursing homes or assisted living facilities. The bill also clarifies that pharmacy services and pharmaceuticals will be billed separately from the hospital stay, and it mandates the authority to adopt necessary administrative rules to facilitate these changes.

Additionally, the bill includes several insertions that outline the authority's responsibilities in managing the payment process, including the requirement for Medicaid managed care organizations to implement uniform administrative processes for payments. It emphasizes the need for hospitals to utilize swing beds or skilled nursing beds when appropriate before billing under the new payment methodology. Overall, the bill aims to ensure that hospitals are fairly compensated for the care of patients who cannot be discharged due to systemic placement issues, while also maintaining the integrity of the billing process for inpatient care.