HB 2331 — Pediatric care rates

Summary

Preventing reductions in access to pediatric primary care and behavioral health services.

Bill Text

Compared against the Revised Code of Washington as published AI-generated reading aid — verify against the official bill.

This bill amends 1 section(s) of the Revised Code of Washington: RCW 74.09.520.

• RCW 74.09.520

  department, including supported living as defined in RCW 71A.10.020; and (iii) Is not discharged from the hospital because placement in the appropriate location described in (a)(ii) of this subsection is not available. (b) Pharmacy services and pharmaceuticals shall be billed by and paid to the hospital separately. (c) The requirements of this subsection do not alter requirements for billing or payment for inpatient care. (d) The authority shall adopt, amend, or rescind such administrative rules as necessary to facilitate calculation and payment of the amounts described in this subsection, including for clients of medicaid managed care organizations. (e) The authority shall adopt rules requiring medicaid managed care organizations to establish specific and uniform administrative and review processes for payment under this subsection. (f) For patients meeting the criteria in (a)(ii)(A) of this subsection, hospitals must utilize swing beds or skilled nursing beds to the extent the services are available within their facility and the associated reimbursement methodology prior to the billing under the methodology in (a) of this subsection, if the hospital determines that such swing bed or skilled nursing bed placement is appropriate for the patient's care needs, the patient is appropriate for the existing patient mix, and appropriate staffing is available. (14) The authority shall adopt rules that establish a standardized definition and reporting mechanism for wait times for pediatric primary care and applied behavior analysis service codes by December 31, 2026. (15) Beginning with the fiscal year that starts July 1, 2027, the authority may not reduce medical assistance reimbursement rates for any pediatric primary care or applied behavior analysis service code if the average statewide waitlist for that service exceeds 30 days. (16) Beginning with the fiscal year that starts July 1, 2027, if the agency-wide appropriation authority is less than the agency's appropriation authority for the previous fiscal year, reductions must be made in the following order: (a) First, to administrative costs including but not limited to new contracts, goods, travel, and vacancies; (b) Second, to nonbargained executive management salaries and wages; and (c) Lastly, to reimbursement rates affecting benefit and client services. (17) Beginning with the fiscal year that starts July 1, 2027, if the legislature provides a rate increase for pediatric primary care or applied behavior analysis service codes in the omnibus operating budget, it must be applied as a distinct layer in addition to the base rate. --- END ---

  amended

Action History

1. January 12, 2026

   First reading, referred to Appropriations.

Sponsors

• (Penner) · Primary

Subjects