1392-S AMS RICC S3010.2
SHB 1392 - S AMD TO WM COMM AMD (S-2795.1/25) 375
By Senator Riccelli
ADOPTED 04/14/2025
On page 2, line 19, after "of" strike "$18" and insert "$16"
On page 2, line 35, after "first" strike "3,000,000" and insert "2,300,000"
On page 2, line 38, after "first" strike "3,000,000" and insert "2,300,000"
On page 5, line 21, after "services in" strike "the amount of $35,991,000" and insert "an amount not to exceed $35,000,000"
On page 6, beginning on line 3, after "(1)" strike all material through "subsection." on line 21 and insert "The medicaid access program is hereby created.
(2) By January 1st of the second plan year after conditions of section 2 of this act are met, professional services rates for anesthesia, diagnostics, intense outpatient, opioid treatment programs, emergency room, inpatient and outpatient surgery, inpatient visits, low-level behavioral health, maternity services, office and home visits, consults, office administered drugs, vision, and other physician services, for services that are not reimbursed at or above medicare rates as of December 31, 2024, must be increased uniformly across professional service categories by a percentage of corresponding medicare rates as of December 31, 2024, based on availability of funds in the account created in section 5 of this act for rate increases from collections in the preceding plan year.
(3) By January 1st of the third plan year after the conditions of section 2 of this act are met, and annually thereafter, the rates for all services listed in subsection (2) of this section shall be adjusted using the most recently published medicare economic index available at the time rates are established for the plan year."
Renumber the remaining subsection consecutively and correct any internal references accordingly.
EFFECT: • Changes the amount the Health Care Authority shall assess managed care organizations in the first year following plan approval from $18 to $16.
• Reduces the number of member months to which the assessment may be applied from 3,000,000 to 2,300,000 for both managed care organizations and health carriers.
• Changes the amount of funding that may be used in lieu of state general fund from $35,991,000 to not exceed $35,000,000.
• Clarifies how professional rate services increases are calculated under the Medicaid Access Program and to which services these increases apply.
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