Senate Bill 5807 modifies the wellness programs offered through public and school employee health benefit plans. The bill discontinues the "smart health program," including its wellness incentive and online portal, for these employees, effective January 1, 2028. While employees who meet eligibility requirements for an incentive by December 31, 2027, will still receive it in the 2028 plan year, no new wellness incentives can be earned after that date. The legislation shifts the focus to broader wellness initiatives that emphasize preventative health strategies.
Senate Bill 5388 revises how behavioral health services, including substance use disorder treatment, are regulated for individuals in Washington state correctional facilities. Rather than requiring these services to be licensed by the Department of Health (DOH), the bill shifts to a monitoring process. The Department of Corrections (DOC) and DOH will jointly establish standards for these services, which the DOH will then monitor through annual inspections for compliance. The DOC must implement these standards by July 1, 2027, with DOH beginning annual inspections and providing technical assistance from that date forward.
This bill updates and modernizes the Washington state health plan by revising the duties of the Office of Financial Management (OFM) regarding health planning. It designates OFM as the coordinating body for strategic health planning and expands its access to various health care data sources, such as the all-payer claims database, to inform its efforts. OFM is now required to develop a statewide health resources strategy, in coordination with stakeholders, to establish policies and goals for health care facility and service availability, quality, and cost by geographic region. The bill also updates definitions for various health facilities, including changing "psychiatric hospitals" to "behavioral health hospitals."
SB 5101 expands existing Washington State protections for victims of domestic violence, sexual assault, and stalking to also include employees who are victims of hate crimes or bias incidents, or whose family members are victims. The bill allows these employees to take reasonable leave from work, which can be intermittent or on a reduced schedule, with or without pay. This leave can be used for reasons such as seeking legal assistance, medical treatment, counseling, or engaging in safety planning related to the hate crime. Employers are required to provide reasonable safety accommodations and may ask for verification of the incident and the need for leave.
SB 5291 strengthens the WA Cares long-term care program by implementing recommendations from the long-term services and supports trust commission. The bill allows individuals who have paid into the program for at least three years while working in Washington to continue their participation and eligibility for benefits even if they move out of state. It also establishes a clear process for how the program's benefit unit, currently up to $100, will be adjusted annually for inflation using a specific consumer price index. Additionally, the bill expands the definition of approved services to explicitly include long-term services and supports provided in nursing homes.
SB 5083 aims to ensure access to primary care, behavioral health, and affordable hospital services for public employees and their dependents in Washington state. It sets caps on how much health carriers can reimburse in-network hospitals for inpatient and outpatient services, generally limiting them to 200% of Medicare rates in 2027 and 190% in 2029, with higher limits for children's specialty hospitals. The bill also mandates minimum reimbursement rates for in-network primary care and non-facility-based behavioral health services (150% of Medicare) and for rural critical access hospitals. Additionally, it requires certain hospitals to contract with health carriers serving public employees and mandates data sharing with the Health Care Authority for monitoring.
HB 2051 concerns payments made to acute care hospitals for Medicaid patients who are medically ready for discharge but cannot easily be moved to another care setting. The bill directly affects these hospitals and the Medicaid patients requiring extended care. It reenacts and amends RCW 74.09.520 to establish or modify the payment structure for the care of these specific patients. This aims to address the challenges hospitals face when patients are difficult to discharge.
House Bill 1392 establishes the Medicaid Access Program in Washington state, directly affecting health carriers and Medicaid managed care organizations. The bill implements an annual "covered lives assessment" on these entities, with specific per-member-per-month rates, to fund the program. Implementation of these assessments and the program is conditional upon federal approval from the Centers for Medicare and Medicaid Services, along with state appropriation certifications and contract amendments.
HB 1382 modernizes Washington's statewide all-payer health care claims database, which collects medical and pharmacy claims data from various public and private health care payers. The bill updates reporting requirements and data disclosure standards for this database, aiming to improve transparency in health care costs and quality. It revises the process for selecting and overseeing the "lead organization" responsible for managing the database, allowing the Health Care Authority to either act as the lead or select one through a competitive process. Additionally, it specifies criteria for the lead organization and outlines entities, such as health plans or hospitals, that are ineligible for the role. The bill also details responsibilities for data vendors who collect and process the claims information to ensure data quality and security.
HB 1213 expands protections for workers in Washington's state paid family and medical leave program. The bill requires the department to enhance outreach to employees, explaining their eligibility, application process, and reinstatement and nondiscrimination rights. It also mandates increased outreach to employers about their responsibilities and authorizes the department to audit employer records for compliance. Additionally, the bill clarifies premium collection and calculation methods, and ensures the confidentiality of employee information within the program.
