Washington 2025-2026 Regular Session Status: Enacted Bipartisan · 2 R · 1 D cosponsors

SB 5124 — Establishing network adequacy standards for skilled nursing facilities and rehabilitation hospitals.

Last action — Effective date 6/11/2026.

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed Senate
  4. ✓
    Passed House
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced December 30, 2024. Enacted.

Signed by Governor Bob Ferguson (Democratic) on March 24, 2026.

Odds of enactment

High chance

Based 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

Likely to advance 92% · high confidence

  • Enacted

    Current position in the legislative process.

  • 3 sponsors

    1 primary, 2 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (2 R · 1 D) — cross-party backing.

  • 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

79 added · 79 removed

Plain-language change summary

The revised version of SB 5124 changes the terminology from "nursing homes" to "skilled nursing facilities," and it shortens the deadline for developing network adequacy standards from January 1, 2028, to June 30, 2026. Additionally, it emphasizes the inclusion of skilled nursing and rehabilitation facilities in the standard-setting process, ensuring that any developed standards consider the need for care to be local to the community. These changes aim to improve access to necessary care and ensure that it is appropriately tailored to local needs, which can significantly affect patient outcomes and community health resources.

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ENGROSSED SUBSTITUTE SENATE BILL 5124 State of Washington 69th Legislature 2025 Regular Session By Senate Health & Long-Term Care (originally sponsored by Senators Muzzall, Chapman, and Dozier) READ FIRST TIME 02/10/25.
S-0436.1 SENATE BILL 5124 State of Washington 69th Legislature 2025 Regular Session By Senators Muzzall, Chapman, and Dozier Prefiled 12/30/24.
AN ACT Relating to increasing patient access to timely and medically necessary postacute care by establishing network adequacy standards for nursing homes and inpatient rehabilitation facilities within managed care contracts for medical assistance programs;
Read first time 01/13/25.
Referred to Committee on Health & Long-Term Care.
AN ACT Relating to increasing patient access to timely and medically necessary postacute care by establishing network adequacy standards for skilled nursing facilities and rehabilitation hospitals within managed care contracts for medical assistance programs;
(2) In order to facilitate more access to postacute care services, the authority shall establish and adopt network adequacy standards for postacute care services by no later than January 1, 2028.
(2) In order to facilitate more access to postacute care services, the authority shall establish and adopt network adequacy standards for postacute care services by no later than June 30, 2026.
Network adequacy standards development must include nursing homes licensed under chapter 18.51 RCW and inpatient rehabilitation facilities licensed under chapter 70.41 RCW.
Network adequacy standards development must include skilled nursing facilities licensed under chapter 18.51 RCW and inpatient rehabilitation facilities licensed under chapter 70.41 RCW.
(a) Network adequacy standards for nursing homes must take into consideration the Washington medicaid principle of keeping care local p.
(a) Network adequacy standards for skilled nursing facilities must take into consideration the Washington medicaid principle of p.
1 ESSB 5124 to an enrollee's community and any geographic adequacy threshold should not be broader than the regional service area a managed care organization is contracted to serve.
1 SB 5124 keeping care local to an enrollee's community and any geographic adequacy threshold should not be broader than the regional service area a managed care organization is contracted to serve.
(a) Stakeholders must include hospitals, nursing homes, managed care organizations, and any associations representing members of these groups.
(a) Stakeholders must include hospitals, skilled nursing facilities, managed care organizations, and any associations representing members of these groups.
(4) Network adequacy standards for postacute care services do not alter the ability of a facility to determine whether the facility can p.
p.
2 ESSB 5124 meet the needs of a prospective resident through available staffing and reasonable accommodations.
2 SB 5124 (4) The authority shall include these network adequacy standards as part of the federal access monitoring requirements in 42 C.F.R.
438, including network adequacy secret shopper reviews.
Sec.
3 ESSB 5124 (e)(i) In negotiating with managed care organizations the authority shall adopt a uniform procedure to enter into contractual arrangements, including:
3 SB 5124 (e)(i) In negotiating with managed care organizations the authority shall adopt a uniform procedure to enter into contractual arrangements, including:
4 ESSB 5124 not possible or feasible, the authority may enter into prepaid capitation contracts that do not include inpatient care;
4 SB 5124 not possible or feasible, the authority may enter into prepaid capitation contracts that do not include inpatient care;
5 ESSB 5124 (b) Managed care organizations should compete for the award of contracts and assignment of medicaid beneficiaries who do not voluntarily select a contracting system, based upon:
5 SB 5124 (b) Managed care organizations should compete for the award of contracts and assignment of medicaid beneficiaries who do not voluntarily select a contracting system, based upon:
6 ESSB 5124 substance use disorder treatment providers to provide access to primary care services integrated into behavioral health clinical settings, for individuals with behavioral health and medical comorbidities.
6 SB 5124 substance use disorder treatment providers to provide access to primary care services integrated into behavioral health clinical settings, for individuals with behavioral health and medical comorbidities.
(12) Managed care organization contracts or amendments effective on or after July 1, 2028, shall be required to meet network adequacy requirements established under this chapter for postacute care p.
(12) Managed care organization contracts or amendments effective on or after January 1, 2027, shall be required to meet network adequacy requirements established under this chapter for postacute p.
7 ESSB 5124 services, including nursing homes licensed under chapter 18.51 RCW, inpatient rehabilitation facilities licensed under chapter 70.41 RCW, and any other postacute care services the authority determines necessary to increase access to a full continuum of care for medicaid enrollees.
7 SB 5124 care services, including skilled nursing facility providers licensed under chapter 18.51 RCW, rehabilitation hospitals licensed under chapter 70.41 RCW, and any other postacute care services the authority determines necessary to increase access to a full continuum of care for medicaid enrollees.
8 ESSB 5124
8 SB 5124
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Action History

  1. Effective date 6/11/2026.

  2. Chapter 206, 2026 Laws.

  3. Governor signed.

  4. Delivered to Governor.

  5. Speaker signed.

  6. President signed.

  7. Third reading, passed; yeas, 96; nays, 0; absent, 0; excused, 2.

  8. Rules suspended. Placed on Third Reading.

  9. Rules Committee relieved of further consideration. Placed on second reading.

  10. Referred to Rules 2 Review.

  11. APP - Majority; do pass.

  12. Executive action taken in the House Committee on Appropriations at 10:30 AM.

  13. Public hearing in the House Committee on Appropriations at 1:30 PM.

  14. Referred to Appropriations.

  15. HCW - Majority; do pass.

  16. Executive action taken in the House Committee on Health Care & Wellness at 8:00 AM.

  17. Public hearing in the House Committee on Health Care & Wellness at 8:30 AM.

  18. First reading, referred to Health Care & Wellness.

  19. Third reading, passed; yeas, 49; nays, 0; absent, 0; excused, 0.

  20. Rules suspended. Placed on Third Reading.

  21. Floor amendment(s) adopted.

  22. Returned to second reading for amendment.

  23. Rules suspended.

  24. Placed on third reading by Rules Committee.

  25. By resolution, reintroduced and retained in present status.

  26. By resolution, returned to Senate Rules Committee for third reading.

  27. Rules Committee relieved of further consideration. Placed on second reading.

  28. Referred to Rules 2 Review.

  29. APP - Majority; do pass with amendment(s) by Health Care & Wellness.

  30. Executive action taken in the House Committee on Appropriations at 10:30 AM.

  31. Public hearing in the House Committee on Appropriations at 1:30 PM.

  32. Referred to Appropriations.

  33. HCW - Majority; do pass with amendment(s).

  34. Executive action taken in the House Committee on Health Care & Wellness at 1:30 PM.

  35. Public hearing in the House Committee on Health Care & Wellness at 1:30 PM.

  36. First reading, referred to Health Care & Wellness.

  37. Third reading, passed; yeas, 49; nays, 0; absent, 0; excused, 0.

  38. Rules suspended. Placed on Third Reading.

  39. 1st substitute bill substituted (HLTC 25).

  40. Placed on second reading by Rules Committee.

  41. Passed to Rules Committee for second reading.

  42. WM - Majority; without recommendation.

  43. Executive action taken in the Senate Committee on Ways & Means at 4:00 PM.

  44. Referred to Ways & Means.

  45. And refer to Ways & Means.

  46. HLTC - Majority; 1st substitute bill be substituted, do pass.

  47. Executive action taken in the Senate Committee on Health & Long-Term Care at 8:00 AM.

  48. Public hearing in the Senate Committee on Health & Long-Term Care at 10:30 AM.

  49. First reading, referred to Health & Long-Term Care.

  50. Prefiled for introduction.

Sponsors

Sponsorship breakdown

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1 sponsors · 2 co-sponsors · 148 not signed on

Sponsors (1)

Co-sponsors (2)

Not signed on (148)

148 members have not signed on to this bill.

Show all 148 →

"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.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

3rd Reading & Final Passage (#13)

Passed 96 Yea · 0 Nay · 2 Other
Party YeaNayPresentNot Voting
Republican 37001
Democrat 59001
Total 96002
% of votes cast 98%0%0%2%
How each member voted (98)
Member Party Vote
Adam Bernbaum Democrat Yea
Adison Richards Democrat Yea
Adrian Cortes Democrat Yea
Alex Ramel Democrat Yea
Alicia Rule Democrat Yea
Amy Walen Democrat Yea
April Berg Democrat Yea
Beth Doglio Democrat Yea
Brandy Donaghy Democrat Yea
Brianna Thomas 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
Edwin Obras Democrat Yea
Gerry Pollet Democrat Yea
Greg Nance Democrat Yea
Jake Fey Democrat Yea
Jamila Taylor Democrat Yea
Janice Zahn Democrat Yea
Javier Valdez Democrat Yea
Joe Fitzgibbon Democrat Yea
Joe Timmons Democrat Yea
Julia Reed Democrat Yea
Kristine Reeves Democrat Yea
Larry Springer Democrat Yea
Lauren Davis Democrat Yea
Laurie Jinkins Democrat Yea
Lillian Ortiz-Self Democrat Yea
Lisa Callan Democrat Yea
Lisa Parshley Democrat Yea
Liz Berry Democrat Yea
Mari Leavitt Democrat Yea
Mary Fosse Democrat Yea
Melanie Morgan Democrat Yea
Mia Gregerson Democrat Yea
Monica Jurado Stonier Democrat Yea
My-Linh Thai Democrat Yea
Natasha Hill Democrat Yea
Nicole Macri Democrat Yea
Osman Salahuddin Democrat Yea
Roger Goodman Democrat Yea
Sharlett Mena Democrat Yea
Sharon Tomiko Santos Democrat Yea
Sharon Wylie Democrat Yea
Shaun Scott Democrat Yea
Shelley Kloba Democrat Yea
Steve Bergquist Democrat Yea
Steve Tharinger Democrat Not Voting
Strom Peterson Democrat Yea
Tarra Simmons Democrat Yea
Timm Ormsby Democrat Yea
Zach Hall Democrat Yea
Alex Ybarra Republican Yea
Andrew Barkis Republican Yea
Andrew Engell Republican Yea
April Connors Republican Yea
Brian Burnett Republican Yea
Carolyn Eslick Republican Not Voting
Chris Corry Republican Yea
Cyndy Jacobsen Republican Yea
Dan Griffey Republican Yea
David Stuebe Republican Yea
Deb Manjarrez Republican Yea
Drew Stokesbary Republican Yea
Ed Orcutt Republican Yea
Gloria Mendoza Republican Yea
Hunter Abell Republican Yea
Jenny Graham Republican Yea
Jeremie Dufault Republican Yea
Jim Walsh Republican Yea
Joe Schmick Republican Yea
Joel McEntire Republican Yea
John Ley Republican Yea
Joshua Penner Republican Yea
Kevin Waters Republican Yea
Mark Klicker Republican Yea
Mary Dye Republican Yea
Matt Marshall Republican Yea
Michael Keaton Republican Yea
Mike Steele Republican Yea
Mike Volz Republican Yea
Peter Abbarno Republican Yea
Rob Chase 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

Official roll call →

3rd Reading & Final Passage (#8)

Passed 49 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democrat 30000
Republican 19000
Total 49000
% of votes cast 100%0%0%0%
How each member voted (49)
Member Party Vote
Adrian Cortes Democrat Yea
Annette Cleveland Democrat Yea
Bob Hasegawa Democrat Yea
Claire Wilson Democrat Yea
Claudia Kauffman Democrat Yea
Deborah Krishnadasan Democrat Yea
Derek Stanford Democrat Yea
Drew Hansen Democrat Yea
Emily Alvarado Democrat Yea
Jamie Pedersen Democrat Yea
Javier Valdez Democrat Yea
Jesse Salomon Democrat Yea
Jessica Bateman Democrat Yea
John Lovick Democrat Yea
June Robinson Democrat Yea
Lisa Wellman Democrat Yea
Liz Lovelett Democrat Yea
Manka Dhingra Democrat Yea
Marcus Riccelli Democrat Yea
Marko Liias Democrat Yea
Mike Chapman Democrat Yea
Noel Frame Democrat Yea
Rebecca Saldaña Democrat Yea
Sharon Shewmake Democrat Yea
Steve Conway Democrat Yea
T'wina Nobles Democrat Yea
Tina Orwall Democrat Yea
Vandana Slatter 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 Goehner Republican Yea
Keith Wagoner Republican Yea
Leonard Christian Republican Yea
Mark Schoesler Republican Yea
Matt Boehnke Republican Yea
Nikki Torres Republican Yea
Paul Harris Republican Yea
Perry Dozier Republican Yea
Phil Fortunato Republican Yea
Ron Muzzall Republican Yea
Shelly Short Republican Yea

Official roll call →

3rd Reading & Final Passage (#24)

Passed 49 Yea · 0 Nay
Party YeaNayPresentNot Voting
Democrat 30000
Republican 19000
Total 49000
% of votes cast 100%0%0%0%
How each member voted (49)
Member Party Vote
Adrian Cortes Democrat Yea
Annette Cleveland Democrat Yea
Bill Ramos Democrat Yea
Bob Hasegawa Democrat Yea
Claire Wilson Democrat Yea
Claudia Kauffman Democrat Yea
Deborah Krishnadasan Democrat Yea
Derek Stanford Democrat Yea
Drew Hansen Democrat Yea
Emily Alvarado Democrat Yea
Jamie Pedersen Democrat Yea
Javier Valdez Democrat Yea
Jesse Salomon Democrat Yea
Jessica Bateman Democrat Yea
John Lovick Democrat Yea
June Robinson Democrat Yea
Lisa Wellman Democrat Yea
Liz Lovelett Democrat Yea
Manka Dhingra Democrat Yea
Marcus Riccelli Democrat Yea
Marko Liias Democrat Yea
Mike Chapman Democrat Yea
Noel Frame Democrat Yea
Rebecca Saldaña Democrat Yea
Sharon Shewmake Democrat Yea
Steve Conway Democrat Yea
T'wina Nobles Democrat Yea
Tina Orwall Democrat Yea
Vandana Slatter 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 Goehner Republican Yea
Keith Wagoner Republican Yea
Leonard Christian Republican Yea
Mark Schoesler Republican Yea
Matt Boehnke Republican Yea
Nikki Torres Republican Yea
Paul Harris Republican Yea
Perry Dozier Republican Yea
Phil Fortunato Republican Yea
Ron Muzzall Republican Yea
Shelly Short Republican Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

Who sponsors SB 5124?
SB 5124 is sponsored by Perry Dozier (Republican), Mike Chapman (Democrat), and Ron Muzzall (Republican).
What is the current status of SB 5124?
This bill has been enacted into law. Introduced December 30, 2024. Enacted.
Where can I track SB 5124?
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