Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 1864
Brief Description: Transporting patients by ambulance to facilities other than emergency departments.
Sponsors: Representatives Thomas, Griffey, Doglio, Parshley, Rule, Fosse, Timmons, Farivar, Reed, Springer, Ramel, Nance, Cortes, Simmons, Peterson, Macri, Street, Salahuddin, Obras, Pollet, Zahn and Hill.
Brief Summary of Bill
  • Authorizes ambulance services to transport patients to facilities that are not emergency departments, such as urgent care clinics, as authorized in regional emergency medical services and trauma care plans (regional plans).
  • Directs health carriers, public and school employee health plans, and medical assistance programs to cover ambulance transports to facilities that are not emergency departments, as authorized in the regional plans.
Hearing Date: 2/14/25
Staff: Chris Blake (786-7392).
Background:

Ambulance services are licensed by the Department of Health to provide prehospital care or interfacility transportation for patients consistent with regional and state plans, and according to patient care procedures.  Patient care procedures are written guidelines adopted as a component of regional emergency medical services and trauma care plans.  The guidelines identify several elements necessary to coordinate the provision of emergency services, including the type of facility to receive the patient.  Ambulance services may transport patients to both medical and nonmedical facilities, such as a mental health facility or substance use disorder program.

 

Health carriers, public and school employee health plans, and medical assistance programs provide coverage for medically necessary ambulance transports.  Health carriers must cover ground ambulance services to an emergency department as well as transports to behavioral health emergency services providers.  The Uniform Medical Plan provides coverage for ambulance services in emergency situations or when other forms of transportation are unsafe due to the patient's medical condition.  Medical assistance programs cover ambulance services for emergency and interfacility transports, including transports to behavioral health facilities.  Transports may be covered to a physician's office in limited nonemergency situations, but medical assistance programs do not cover ambulance transports to urgent care clinics or 24-hour walk-in clinics.
Summary of Bill:

In addition to the authority to transport patients to nonmedical facilities, such as behavioral health facilities, ambulance services may transport patients to facilities that are not emergency departments, such as urgent care clinics.  The transport to a nonemergency department must be authorized in regional emergency medical services and trauma care plans (regional plans).  The definition of "patient care procedures," the contents of regional plans, and liability protections for ambulance services, emergency medical services personnel, and medical program directors are modified to include nonemergency department facilities, such as urgent care clinics.

 

The Health Care Authority's reimbursement methodology for ambulance services must allow for transporting medical assistance program enrollees to facilities that are not emergency departments, such as urgent care clinics, as authorized in the regional plans.  Beginning January 1, 2026, health carriers must cover ambulance transportation to facilities that are not emergency departments, as authorized in the regional plans.  Beginning January 1, 2026, health plans offered to public and school employees must cover ambulance transportation to facilities that are not emergency departments or behavioral health facilities, as authorized in the regional plans.

 

References to "chemical dependency" are updated to "substance use disorder." 
Appropriation: None.
Fiscal Note: Requested on February 7, 2025.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.