SB 5497 — Concerning medicaid expenditures.
Last action — Effective date 7/23/2023.
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✓Introduced
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✓In Committee
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✓Passed Senate
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✓Passed House
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✓To Executive
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6Enacted
This bill has been enacted into law. Introduced January 20, 2023. Enacted.
Odds of enactment
High chanceBased on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.
Upgrade to see the exact probability and what's driving it.
A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.
Prognosis
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Enacted
Current position in the legislative process.
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2 sponsors
1 primary, 1 co-sponsors signed on.
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Cleared a recorded vote
Passed 3 recorded votes so far.
Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.
Bill Text
What changed in the latest version
236 added · 161 removedPlain-language change summary
The recent amendment to SB 5497 introduces new sections that emphasize the importance of strong financial management within Washington's Medicaid program. It highlights the responsibility of the Health Care Authority to ensure that Medicaid resources are managed effectively, aiming to provide the right services to the right people at the right time. This change matters because it aims to enhance the efficiency and integrity of Medicaid funding, ensuring that more resources are available to those who truly need them.
CERTIFICATIONS-0751.1 OF ENROLLMENT SENATE BILL 5497 68th Legislature Regular Session Passed by the Senate April 18, 2023 CERTIFICATE Yeas 49 Nays 0 I, Sarah Bannister, Secretary of the Senate of the State of Washington,Washington do68th herebyLegislature certify2023 thatRegular PresidentSession ofBy theSenators SenateL. the attached is SENATE BILL 5497 as passed by the Senate and the House of Representatives on the dates hereon set forth.
Passed by the House April 7, 2023 Yeas 97 Nays 0 Secretary Speaker of the House of Representatives Approved FILED Secretary of State State of Washington Governor of the State of Washington SENATE BILL 5497 AS AMENDED BY THE HOUSE Passed Legislature - 2023 Regular Session State of Washington 68th Legislature 2023 Regular Session By Senators L.
adding a new section to chapter 43.41 RCW;
(1) The department is designated as the single state agency to administer the following public assistance programs:
1 SB 5497.PL5497 (a)(1) TemporaryThe assistancedepartment ((tois [for]))designated foras needythe families;single state agency to administer the following public assistance programs:
(a) Temporary assistance ((to [for])) for needy families;
(1) The authority shall provide administrative oversight for all funds received under the medical assistance program, as codified in p.
2 SB 5497.PL5497 (1) The authority shall provide administrative oversight for all funds received under the medical assistance program, as codified in Title XIX of the federal social security act, the state children's health insurance program, as codified in Title XXI of the federal social security act, and any other federal medicaid funding to ensure that:
(a) Conducting risk assessments or evaluating leads with established risk factors;
(b) Relying on data analytics to generate leads;
3 SB 5497.PL5497 (c)(a) Conducting arisk preliminaryassessments reviewor ofevaluating incomingleads leads,with whichestablished includesrisk analyzingfactors; data about the lead and may include reviewing records such as billing histories;
(b) Relying on data analytics to generate leads;
(c) Conducting a preliminary review of incoming leads, which includes analyzing data about the lead and may include reviewing records such as billing histories;
and (e)p. Ensuring all contracts with managed care organizations are updated as appropriate to reflect program integrity requirements.
4 SB 5497 (e) Ensuring all contracts with managed care organizations are updated as appropriate to reflect program integrity requirements.
NEW SECTION.
Sec.
5.
A new section is added to chapter 43.41 RCW to read as follows:
(1) The medicaid expenditure forecast work group is hereby created.
The work group shall be managed by the office of financial management.
(2) The office shall employ a forecast manager and appropriate staff to:
(a) Oversee preparation of medicaid expenditure forecasting products;
(b) Develop necessary infrastructure and programming for the preparation of medicaid expenditure forecasting products;
(c) Coordinate production of forecasts;
and (d) Develop primary trends, estimates of federal medical assistance percentages, and other estimates required to generate the forecast.
(3) Members of the work group shall consist of:
(a) Staff listed under subsection (2) of this section;
(b) The senior analyst assigned to medicaid from the office;
(c) Staff from the health care authority;
(d) Senior fiscal analysts from the two fiscal committees of the legislature assigned to medicaid;
(e) An actuary from the office of the state actuary;
and (f) Other staff as deemed necessary by the work group.
(4) To ensure the duties of the work group are carried out in a timely, transparent manner, the office shall develop a charter, in consultation with the members of the work group, that specifies:
(a) The purpose of the work group;
(b) Its intended customers;
(c) Detailed roles and responsibilities of each member of the work group;
(d) Protocols, such as the level of agreement necessary, to finalize a decision;
(e) Rules for settling a disagreement;
(f) How inquiries and requests for analysis are prioritized;
Show all 68 changed lines (28 more)
(g) How assumptions are documented and communicated to intended customers;
(h) How to compare prior forecasts against expenditures;
and p.
5 SB 5497 (i) Quality assurance mechanisms.
(5) The work group shall provide technical support to the governor's office and the fiscal committees of the legislature.
To promote the free flow of information and to promote legislative and executive input in the development of assumptions and preparation of forecasts, immediate access to all information and statistical models relating to the forecast shall be available to the work group.
Meetings of the work group may be called by any member of the group for the purpose of assisting the work group, reviewing forecasts, or for any other purpose that may assist the group.
(6) Members from the health care authority shall provide all data, documents, information, and responses to the work group necessary to develop the forecast in the time frames agreed upon by the work group.
(7) All members shall review information necessary to develop the forecast in the time frames agreed upon by the work group.
(8) In consultation with the work group and subject to the approval of the work group, the forecast manager shall prepare:
(a) An official forecast;
and (b) Other forecasts based on alternative assumptions as the work group may determine.
(9) The forecast manager shall submit official forecasts and any unofficial forecasts prepared under this section to the office and the staff of appropriate fiscal committees of the legislature.
The forecasts shall be submitted at least twice each year and on such dates as the work group determines will facilitate the development of budget proposals by the governor and the legislature.
(10) The forecasts shall be used to develop budget estimates for the office and the fiscal committees of the legislature.
The official forecast prepared under this section shall be the basis of the governor's budget document and utilized by the legislature in the development of the omnibus biennial appropriations act.
(11) The health care authority shall:
(a) Provide to the forecast manager immediate access to all information relating to the forecast;
(b) Work with its contracted actuary and the work group to develop methods and metrics related to managed care program integrity activity that shall be incorporated into annual managed care rate setting.
This activity shall be done during the normal course of rate p.
6 SB 5497 setting with the work group and shall not be conducted separately from the work group;
(c) Work with the work group to ensure the results of program integrity activity are incorporated into the managed care rate setting process in a transparent, timely, measurable, quantifiable manner.
This activity shall be done during the normal course of rate setting with the work group and shall not be conducted separately from the work group;
and (d) Submit reports and data to the work group as soon as the reports and data are available and shall provide to the work group and the forecast manager such additional raw, program-level data or information as may be necessary for discharge of their respective duties.
(12) For purposes of this section:
(a) "Work group" means the medicaid expenditure forecast work group.
(b) "Forecast" means the medicaid expenditure forecast.
47 SB 5497.PL5497
Show all 68 changed rows (28 more)
Action History
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Effective date 7/23/2023.
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Chapter 439, 2023 Laws.
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Governor signed.
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Delivered to Governor.
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Speaker signed.
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President signed.
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Passed final passage; yeas, 49; nays, 0; absent, 0; excused, 0.
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Senate concurred in House amendments.
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Third reading, passed; yeas, 97; nays, 0; absent, 0; excused, 1.
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Rules suspended. Placed on Third Reading.
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Committee amendment(s) adopted with no other amendments.
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Rules Committee relieved of further consideration. Placed on second reading.
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Referred to Rules 2 Review.
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APP - Majority; do pass with amendment(s).
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Public hearing and executive action taken in the House Committee on Appropriations at 9:00 AM.
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Referred to Appropriations.
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HCW - Majority; do pass.
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Executive action taken in the House Committee on Health Care & Wellness at 8:00 AM.
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Public hearing in the House Committee on Health Care & Wellness at 1:30 PM.
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First reading, referred to Health Care & Wellness.
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Third reading, passed; yeas, 45; nays, 3; absent, 0; excused, 1.
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Rules suspended. Placed on Third Reading.
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Placed on second reading by Rules Committee.
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Passed to Rules Committee for second reading.
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Minority; without recommendation.
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Minority; do not pass.
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WM - Majority; do pass.
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Executive action taken in the Senate Committee on Ways & Means at 4:00 PM.
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Public hearing in the Senate Committee on Ways & Means at 4:00 PM.
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Referred to Ways & Means.
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And refer to Ways & Means.
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HLTC - Majority; without recommendation.
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Executive action taken in the Senate Committee on Health & Long Term Care at 10:30 AM.
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First reading, referred to Health & Long Term Care.
Sponsors
- Rolfes · Cosponsor
- L. Wilson · Primary
Sponsorship breakdown
Export CSV (upgrade) →1 sponsors · 1 co-sponsors · 149 not signed on · 3 voted No
Sponsors (1)
Co-sponsors (1)
- Rolfes
Not signed on (149)
149 members have not signed on to this bill.
Show all 149 →"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.
Votes
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 11 | 0 | 0 | 0 |
| Republican | 16 | 0 | 0 | 0 |
| Democrat | 22 | 0 | 0 | 0 |
| Total | 49 | 0 | 0 | 0 |
| % of votes cast | 100% | 0% | 0% | 0% |
How each member voted (49)
| Member | Party | Vote |
|---|---|---|
| Billig | — | Yea |
| Hawkins | — | Yea |
| Keiser | — | Yea |
| Kuderer | — | Yea |
| Mullet | — | Yea |
| Padden | — | Yea |
| Randall | — | Yea |
| Rivers | — | Yea |
| Rolfes | — | Yea |
| Van De Wege | — | Yea |
| Wilson, L. | — | Yea |
| Annette Cleveland | Democrat | Yea |
| Bob Hasegawa | Democrat | Yea |
| Claire Wilson | Democrat | Yea |
| Claudia Kauffman | Democrat | Yea |
| Derek Stanford | Democrat | Yea |
| Jamie Pedersen | Democrat | Yea |
| Javier Valdez | Democrat | Yea |
| Jesse Salomon | Democrat | Yea |
| Joe Nguyen | Democrat | Yea |
| John Lovick | Democrat | Yea |
| June Robinson | Democrat | Yea |
| Lisa Wellman | Democrat | Yea |
| Liz Lovelett | Democrat | Yea |
| Manka Dhingra | Democrat | Yea |
| Marko Liias | Democrat | Yea |
| Noel Frame | Democrat | Yea |
| Rebecca Saldaña | Democrat | Yea |
| Sharon Shewmake | Democrat | Yea |
| Steve Conway | Democrat | Yea |
| T'wina Nobles | Democrat | Yea |
| Victoria Hunt | Democrat | Yea |
| Yasmin Trudeau | Democrat | Yea |
| Chris Gildon | Republican | Yea |
| Curtis King | Republican | Yea |
| Drew MacEwen | Republican | Yea |
| Jeff Holy | Republican | Yea |
| Jeff Wilson | Republican | Yea |
| Jim McCune | Republican | Yea |
| John Braun | Republican | Yea |
| Judy Warnick | Republican | Yea |
| Keith Wagoner | Republican | Yea |
| Mark Schoesler | Republican | Yea |
| Matt Boehnke | Republican | Yea |
| Nikki Torres | Republican | Yea |
| Perry Dozier | Republican | Yea |
| Phil Fortunato | Republican | Yea |
| Ron Muzzall | Republican | Yea |
| Shelly Short | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Republican | 30 | 0 | 0 | 0 |
| Democrat | 56 | 0 | 0 | 1 |
| Unaffiliated | 11 | 0 | 0 | 0 |
| Total | 97 | 0 | 0 | 1 |
| % of votes cast | 99% | 0% | 0% | 1% |
How each member voted (98)
| Member | Party | Vote |
|---|---|---|
| Chambers | — | Yea |
| Chandler | — | Yea |
| Cheney | — | Yea |
| Chopp | — | Yea |
| Hutchins | — | Yea |
| Kretz | — | Yea |
| Maycumber | — | Yea |
| Mosbrucker | — | Yea |
| Robertson | — | Yea |
| Sandlin | — | Yea |
| Wilcox | — | Yea |
| Alex Ramel | Democrat | Yea |
| Alicia Rule | Democrat | Yea |
| Amy Walen | Democrat | Yea |
| April Berg | Democrat | Yea |
| Beth Doglio | Democrat | Yea |
| Bill Ramos | Democrat | Yea |
| Brandy Donaghy | Democrat | Yea |
| Chipalo Street | Democrat | Yea |
| Chris Stearns | Democrat | Yea |
| Cindy Ryu | Democrat | Yea |
| Clyde Shavers | Democrat | Yea |
| Dan Bronoske | Democrat | Yea |
| Darya Farivar | Democrat | Yea |
| Dave Paul | Democrat | Yea |
| David Hackney | Democrat | Yea |
| Davina Duerr | Democrat | Yea |
| Debra Entenman | Democrat | Yea |
| Debra Lekanoff | Democrat | Yea |
| Drew Hansen | Democrat | Yea |
| Emily Alvarado | Democrat | Yea |
| Gerry Pollet | Democrat | Yea |
| Jake Fey | Democrat | Yea |
| Jamila Taylor | Democrat | Yea |
| Jessica Bateman | Democrat | Yea |
| Joe Fitzgibbon | Democrat | Yea |
| Joe Timmons | Democrat | Yea |
| Julia Reed | Democrat | Yea |
| Julio Cortes | Democrat | Yea |
| Kristine Reeves | Democrat | Yea |
| Larry Springer | Democrat | Yea |
| Lauren Davis | Democrat | Yea |
| Laurie Jinkins | Democrat | Yea |
| Lillian Ortiz-Self | Democrat | Not Voting |
| Lisa Callan | Democrat | Yea |
| Liz Berry | Democrat | Yea |
| Marcus Riccelli | Democrat | Yea |
| Mari Leavitt | Democrat | Yea |
| Mary Fosse | Democrat | Yea |
| Melanie Morgan | Democrat | Yea |
| Mia Gregerson | Democrat | Yea |
| Mike Chapman | Democrat | Yea |
| Monica Jurado Stonier | Democrat | Yea |
| My-Linh Thai | Democrat | Yea |
| Nicole Macri | Democrat | Yea |
| Roger Goodman | Democrat | Yea |
| Sharlett Mena | Democrat | Yea |
| Sharon Tomiko Santos | Democrat | Yea |
| Sharon Wylie | Democrat | Yea |
| Shelley Kloba | Democrat | Yea |
| Steve Bergquist | Democrat | Yea |
| Steve Tharinger | Democrat | Yea |
| Strom Peterson | Democrat | Yea |
| Tana Senn | Democrat | Yea |
| Tarra Simmons | Democrat | Yea |
| Timm Ormsby | Democrat | Yea |
| Tina Orwall | Democrat | Yea |
| Vandana Slatter | Democrat | Yea |
| Alex Ybarra | Republican | Yea |
| Andrew Barkis | Republican | Yea |
| April Connors | Republican | Yea |
| Carolyn Eslick | Republican | Yea |
| Chris Corry | Republican | Yea |
| Cyndy Jacobsen | Republican | Yea |
| Dan Griffey | Republican | Yea |
| Drew Stokesbary | Republican | Yea |
| Ed Orcutt | Republican | Yea |
| Jenny Graham | Republican | Yea |
| Jim Walsh | Republican | Yea |
| Joe Schmick | Republican | Yea |
| Joel McEntire | Republican | Yea |
| Keith Goehner | Republican | Yea |
| Kevin Waters | Republican | Yea |
| Leonard Christian | Republican | Yea |
| Mark Klicker | Republican | Yea |
| Mary Dye | Republican | Yea |
| Michelle Valdez | Republican | Yea |
| Mike Steele | Republican | Yea |
| Mike Volz | Republican | Yea |
| Paul Harris | Republican | Yea |
| Peter Abbarno | Republican | Yea |
| Sam Low | Republican | Yea |
| Skyler Rude | Republican | Yea |
| Stephanie Barnard | Republican | Yea |
| Stephanie McClintock | Republican | Yea |
| Suzanne Schmidt | Republican | Yea |
| Tom Dent | Republican | Yea |
| Travis Couture | Republican | Yea |
| Party | Yea | Nay | Present | Not Voting |
|---|---|---|---|---|
| Unaffiliated | 10 | 0 | 0 | 1 |
| Republican | 16 | 0 | 0 | 0 |
| Democrat | 19 | 3 | 0 | 0 |
| Total | 45 | 3 | 0 | 1 |
| % of votes cast | 92% | 6% | 0% | 2% |
How each member voted (49)
| Member | Party | Vote |
|---|---|---|
| Billig | — | Yea |
| Hawkins | — | Yea |
| Keiser | — | Yea |
| Kuderer | — | Yea |
| Mullet | — | Yea |
| Padden | — | Yea |
| Randall | — | Yea |
| Rivers | — | Not Voting |
| Rolfes | — | Yea |
| Van De Wege | — | Yea |
| Wilson, L. | — | Yea |
| Annette Cleveland | Democrat | Yea |
| Bob Hasegawa | Democrat | Yea |
| Claire Wilson | Democrat | Yea |
| Claudia Kauffman | Democrat | Yea |
| Derek Stanford | Democrat | Yea |
| Jamie Pedersen | Democrat | Yea |
| Javier Valdez | Democrat | Yea |
| Jesse Salomon | Democrat | Yea |
| Joe Nguyen | Democrat | Yea |
| John Lovick | Democrat | Yea |
| June Robinson | Democrat | Yea |
| Lisa Wellman | Democrat | Yea |
| Liz Lovelett | Democrat | Yea |
| Manka Dhingra | Democrat | Nay |
| Marko Liias | Democrat | Nay |
| Noel Frame | Democrat | Yea |
| Rebecca Saldaña | Democrat | Yea |
| Sharon Shewmake | Democrat | Yea |
| Steve Conway | Democrat | Yea |
| T'wina Nobles | Democrat | Yea |
| Victoria Hunt | Democrat | Yea |
| Yasmin Trudeau | Democrat | Nay |
| Chris Gildon | Republican | Yea |
| Curtis King | Republican | Yea |
| Drew MacEwen | Republican | Yea |
| Jeff Holy | Republican | Yea |
| Jeff Wilson | Republican | Yea |
| Jim McCune | Republican | Yea |
| John Braun | Republican | Yea |
| Judy Warnick | Republican | Yea |
| Keith Wagoner | Republican | Yea |
| Mark Schoesler | Republican | Yea |
| Matt Boehnke | Republican | Yea |
| Nikki Torres | Republican | Yea |
| Perry Dozier | Republican | Yea |
| Phil Fortunato | Republican | Yea |
| Ron Muzzall | Republican | Yea |
| Shelly Short | Republican | Yea |
Subjects
Frequently asked questions
- Who sponsors SB 5497?
- SB 5497 is sponsored by Rolfes and Wilson, L..
- What is the current status of SB 5497?
- This bill has been enacted into law. Introduced January 20, 2023. Enacted.
- Where can I track SB 5497?
- Track SB 5497 free on One Click Politics — get push/email alerts when it moves.
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