BySenate Ways & Means (originally sponsored by Senators Frockt, Randall, Rolfes, Darneille, Braun, Billig, Salomon, Stanford, Dhingra, Van De Wege, Brown, Carlyle, Cleveland, Conway, Das, Hasegawa, Keiser, King, Kuderer, Liias, Lovelett, McCoy, Mullet, Nguyen, Pedersen, Wellman, and Wilson, C.)

AN ACT Relating to reimbursement for primary care services for medicaid beneficiaries; and adding a new section to chapter 74.09 RCW.

(1) Except as provided in subsection (2) of this section, beginning January 1, 2021, medicaid payment for primary care services that are reimbursed solely at the existing medical assistance rates, furnished by a nurse practitioner, naturopath, physician assistant, osteopathic physician assistant, physician, or osteopathic physician, on a fee-for-service basis as well as through managed health care systems, must be at least fifteen percent above medical assistance rates as in effect on January 1, 2019.

(2) Beginning January 1, 2021, medicaid payment for pediatric critical care, neonatal critical care, and neonatal intensive care services that are reimbursed solely at the existing medical assistance rates, furnished by a nurse practitioner, naturopath, physician assistant, osteopathic physician assistant, physician, or osteopathic physician, on a fee-for-service basis as well as through managed health care systems, must be at least twenty-one percent above medical assistance rates as in effect on January 1, 2019.

(3) The authority must apply reimbursement rates required under this section to payment codes in a manner consistent with the temporary increase in medicaid reimbursement rates under federal rules and guidance in effect on January 1, 2014, implementing the patient protection and affordable care act, except that the authority may not require provider attestations.

(4) The authority must pursue a state plan amendment to require medicaid managed care organizations to increase rates under this section through adoption of a uniform percentage increase for network providers pursuant to 42 C.F.R. Sec. 438.6(c)(1)(iii)(B), as existing on January 1, 2020.