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

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1. A new section is added to chapter 74.09 RCW to read as follows:

(1) Medicaid payment for primary care services that are reimbursed solely at the existing medical assistance rates, furnished by a nurse practitioner, a physician with a primary specialty designation of family medicine, general internal medicine, or pediatric medicine or provided by subspecialists within these primary specialties as recognized in accordance with the American board of medical specialties, the American board of physician specialties, and the American osteopathic association, on a fee-for-service basis as well as through managed health care systems, must be at a rate not less than seventy-five percent of the payment rate that applies to those services and providers under medicare.

(2) 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.

(3) The authority must pursue a state plan amendment to require medicaid managed care organizations to increase primary care rates under this section through adoption of a minimum fee schedule pursuant to 42 C.F.R. Sec. 438.6(c)(1)(iii)(A), as existing on January 1, 2020.

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