Bill > HB1392

This bill creates the Medicaid Access Program, a comprehensive initiative designed to improve healthcare access for Medicaid enrollees in Washington state. The program will impose an annual assessment on health carriers (insurance companies) and Medicaid managed care organizations, collecting funds to increase professional medical service rates for providers who are currently reimbursed below Medicare rates. Health carriers will be assessed $0.50 per member per month, while Medicaid managed care organizations will be assessed $16 per member per month, with the assessment limited to the first 2.3 million member months. By January 1st of the second plan year after federal approval, professional service rates for various medical services like anesthesia, emergency room visits, surgery, and behavioral health services will be increased uniformly based on Medicare rates. The Washington State Health Care Authority will study the program's impact on Medicaid access annually, examining metrics such as service utilization, provider contracts, and patient access measures. The bill requires federal Centers for Medicare and Medicaid Services approval and will expire on January 1, 2027, if such approval is not obtained. A dedicated Medicaid Access Program Account will be created to manage the collected funds, with potential uses including provider payments, administrative expenses, and supporting school-based health services.