The bill amends RCW 74.09.520 to address payment procedures for acute care hospitals regarding Medicaid patients who are difficult to discharge. It establishes that hospitals will be reimbursed for days when a patient does not meet the criteria for acute inpatient care but cannot be discharged due to the unavailability of appropriate placement options, 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 enhance the existing framework for Medicaid services. These include requirements for Medicaid managed care organizations to implement uniform administrative processes for payments and stipulations for hospitals to utilize swing beds or skilled nursing beds when appropriate. The overall aim of the bill is to ensure that patients receive necessary care while also streamlining the payment process for hospitals, thereby addressing the challenges associated with discharging difficult-to-place patients.