States that the purpose of the Washington rural health access preservation pilot is to develop an alternative service and payment system to the critical access hospital authorized under section 1820 of the social security act to sustain essential services in rural communities.

Requires payments for services, delivered by public health care service districts participating in the Washington rural health access preservation pilot to recipients eligible for certain medical assistance programs, to be based on an alternative, value-based payment methodology established by the state health care authority.

Requires the payment methodology to provide sufficient funding to sustain essential services in the areas served, including emergency and primary care services.

Requires funds appropriated for the Washington rural health access preservation pilot to be used to help participating hospitals transition to a new payment methodology.

Provides that this act is null and void if appropriations are not approved.