The bill amends RCW 74.09.5225 to allow rural hospitals located on federally recognized Indian reservations to receive payments based on allowable costs for services provided, regardless of the managed care enrollment status of the beneficiaries. Specifically, it introduces new provisions that state if a rural hospital is designated as a critical access hospital by the Centers for Medicare and Medicaid Services (CMS) on or after January 1, 2026, it will be eligible for payments as outlined in the existing law. Additionally, if the hospital is not designated as a critical access hospital by that date, it can still receive payments for medical assistance programs based on allowable costs, provided it maintains no more than 25 inpatient beds, excluding psychiatric unit beds.

The bill also places a moratorium on additional hospital participation in critical access hospital payments, with exceptions for rural hospitals that applied for certification before January 1, 2005. It outlines the Washington rural health access preservation pilot, which aims to develop alternative service and payment systems for critical access hospitals, ensuring that participating hospitals can transition to new payment methodologies while maintaining essential services in rural communities. The pilot program is subject to specific requirements, including optional participation and the establishment of a value-based payment methodology.

Statutes affected:
Original bill: 74.09.5225