SB 5629 mandates that large group health plans in Washington, issued or renewed on or after January 1, 2026, must include coverage for medically necessary prosthetic limbs and custom orthotic braces. This coverage applies when devices are needed for daily living, essential job activities, or to maximize physical function. The bill also requires coverage for materials, instruction, and reasonable repair or replacement of these devices. It prohibits denying coverage for individuals with disabilities if similar services would be covered for non-disabled persons and requires health plans to report claims data.
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.
SB 5579 prohibits health carriers, facilities, and providers from making public statements about potential or planned contract terminations until 45 days before the termination date, unless legally required. This aims to provide consistent policies for communicating with health plan enrollees and affected communities during contract negotiations. The bill directs the Insurance Commissioner to develop standard templates for patient notices, which must include information on affected facilities, appointment guidance, and continuity of care rights. Violations by carriers can result in monetary penalties, while violations by providers or facilities can be referred to relevant licensing or disciplinary authorities.
HB 1468 repeals numerous existing state accounts across various sectors, such as the Juvenile Accountability Incentive Account and the Washington State Flag Account. Simultaneously, it establishes an annual eight-dollar surcharge on licenses for registered nurses and licensed practical nurses. These surcharge funds will be deposited into a new Nursing Resource Center Account. This account will provide grants to a central nursing resource center. The center's mission is to strengthen Washington's nursing workforce through activities like data collection, trend monitoring, and promoting nursing careers to ensure adequate healthcare staffing.
HB 1709 authorizes trained, parent-designated adults to provide care, including administering emergency medication, to students with adrenal insufficiency in Washington public schools. The bill requires school districts to develop individual health plans for these students and adopt policies for their care, such as medication storage and emergency procedures. Parent-designated adults must volunteer, be authorized by the student's parents, and complete specific training. This legislation also extends liability protection to school districts, employees, and these designated adults who act in good faith according to the student's health plan. This measure aims to ensure students with adrenal insufficiency receive necessary medical support when a school nurse is not available.