March 9, 2026932February 28, 2026490

I, Bernard Dean, Chief Clerk of the House of Representatives of the State of Washington, do hereby certify that the attached is ENGROSSED SUBSTITUTE HOUSE BILL 1187 as passed by the House of Representatives and the Senate on the dates hereon set forth.

Chief Clerk

Secretary of State

State of Washington

ESHB 1187.PLENGROSSED SUBSTITUTE HOUSE BILL 1187SENATEPassed Legislature2026 Regular Session69th Legislature2025 Regular SessionHouse Health Care & Wellness (originally sponsored by Representatives Ryu, Thai, Obras, Macri, Paul, Callan, Pollet, Fey, and Kloba)READ FIRST TIME 02/21/25.Protecting patients involved in motor vehicle accidents from delayed ambulance bills. AN ACT Relating to protecting patients involved in motor vehicle accidents from delayed ambulance bills; adding a new section to chapter 18.73 RCW; and adding a new section to chapter 48.02 RCW. Sec. 1. A new section is added to chapter 18.73 RCW to read as follows:

(1) An ambulance service may not sell or assign medical debt related to ambulance services following a motor vehicle accident to any person licensed under chapter 19.16 RCW until at least 120 days after the initial billing statement for that medical debt has been transmitted to the patient and other responsible party.

(2) For purposes of this section:

(a) "Motor vehicle accident" includes incidents where a pedestrian or bicyclist is struck or otherwise injured by a motor vehicle.

(b) "Initial billing statement" means the first billing statement provided to a patient and other responsible parties by the ground ambulance services organization after care has been rendered. The billing statement may be mailed or provided electronically.

(c) "Other responsible party" means any individual or entity other than the patient who holds a legal or contractual responsibility for paying medical bills.

 Sec. 2. A new section is added to chapter 48.02 RCW to read as follows:

(1) If the commissioner has cause to believe that any ambulance service has engaged in a pattern of unresolved violations of section 1 of this act, the commissioner may submit information to the department of health for action. Prior to submitting information to the department of health or the appropriate disciplining authority, the commissioner may provide the ambulance service with an opportunity to cure the alleged violations or explain why the actions in question did not violate section 1 of this act.

(2) If any ambulance service has engaged in a pattern of unresolved violations of section 1 of this act, the department of health may levy a fine or cost recovery upon the ambulance service in an amount not to exceed the applicable statutory amount per violation and take other action as permitted under the authority of the department. Upon completion of its review of any potential violation submitted by the commissioner or initiated directly by an enrollee, the department of health shall notify the commissioner of the results of the review, including whether the violation was substantiated and any enforcement action taken as a result of a finding of a substantiated violation.