WSHA and hospitals achieve success on policy bills during 2026 legislative session

The 2026 legislative session was among the most successful in WSHA’s history.  

WSHA’s policy agenda aggressively pursued progress for insurer reform, preserving patient access and protecting critical resources. WSHA worked with lawmakers on seven proactive bills. Six of those bills passed, including:   

•      ESSB 5845: Timely payment requirements for health carriers, which requires that clean claims be paid within30 days and regulates requests for additional information. 

•      E2SSB 5395: Prior authorization reform for health insurers, which ensures final denials of prior authorization requests are by qualified clinicians rather than by AI alone and prohibits retroactive denials or modifications for services that have been preauthorized.

•      ESHB 2110: RN EMS specialty care transports, enables registered nurses to accompany patients on interfacility transfers, particularly in rural areas where there are shortages of EMS personnel.
 
•     HB 2113: Supervision of radiologic and MRI technologists performing IV contrast administration, updates and expands the providers that can provide supervision for radiologic and MRI technologists.
 
•     E2SSB 5981: Protections for the 340B drug pricing program, prohibits drug manufacturers from restricting sales or requiring onerous reporting for 340Bdrugs dispensed through contract pharmacies.

•     ESSB 5124: Network adequacy standards for Medicaid managed care organizations for skilled nursing and rehabilitation, which will require Medicaid MCOs to have contracts in place to reduce delays in placing patients to these facilities.  


In the upcoming months, WSHA will provide bulletins detailing these and other major bills. 

WSHA was also able to defeat or amend several pieces of legislation that would have harmed hospitals, including:  

•      2SSB 5387: Corporate practice of health care 

•      ESHB 2548: Health care market standards (health care transaction oversight)

•      ESSB 5993: Prohibiting the collection of interest on medical debt

•      ESSB 5906: Data and personal safety protections related to immigration enforcement in areas of public accommodation 

•     SB 6173: Creating an apple health employer assessment 

•     HB 2100:Payrolltax to fund the Well Washington account   

•    HB 2626:Increasingthe insurance premium tax on certain health insurance providers (would reduce safety net assessment payments to hospitals)   

Hospitals avoid major cuts and obtain tax relief in final state budget 

WSHA also had major success with the budget, with no direct cuts to hospitals, despite ongoing state financial challenges. WSHA successfully opposed proposals to cut payments for Medicaid outpatient hospital services and move the Medicaid pharmacy benefit from managed care to fee for services. Additionally, WSHA helped persuade lawmakers to preserve the adult Medicaid benefit for occupational, physical and speech therapy and secured some relief for hospitals from B&O and sales tax impacts. Check out the Budget Issue of Inside Olympia for more details. (Andrew Busz, [email protected]). 

Legislative session wrap up webinar on 3/26. For a deeper look at the session, be sure to  register to join the legislative session wrap-up webcast at noon on March 26. Attendees will have the opportunity to ask questions and learn about the next steps for newly passed legislation. 

Critical access hospitals face denials of Medicare payment 

WSHA has been in contact with the Centers for Medicare and Medicaid Services (CMS) regarding a widespread system issue disrupting Medicare payment to critical access hospitals throughout the country, including many CAHs in Washington State. The issue affects professional services billed on hospital institution claims through Method II billing. CMS is still gathering information identifying all of the issues that are causing payment denials, including but not limited to issues with provider enrollment. We encourage CAHs experiencing payment issues to reach out to CMS directly at[email protected]. (Jacqueline Barton True, [email protected].)

WSHA and AWPHD report 2025 lobbying expenses for Medicare cost reports 

The Medicare Provider Reimbursement Manual requires hospitals to adjust their Medicare cost reports to eliminate the portion of association dues related to lobbying expenses. Please forward this information to the people in your organization responsible for completing and submitting Medicare cost reports.

The Washington State Hospital Association (WSHA) has determined 26.5 percent of its membership dues were expended in activities that meet the Medicare definition of lobbying for calendar year 2025. For entities that must separately calculate federal lobbying expenditures, 3.2 percent of WSHA membership dues for 2025 were related to federal lobbying expenditures.

For the Association of Washington Public Hospital Districts (AWPHD), 8 percent of its membership dues were expended in activities that meet the Medicare definition of lobbying for calendar year 2025.

If you have questions, please contact Andrew Busz at [email protected]

OIC extends BBPA dispute resolution process until 2028

The Office of the Insurance Commissioner (OIC) announced it will be extending the dispute resolution process under the state’s Balance Billing Protection Act (BBPA) for at least two additional years and will revisit the issue in 2028. Reasons cited by OIC for the extension included comments received on OIC’s request for information, the continued high volume of cases in the NSA IDR process, pending federal litigation related to the NSA IDR process, pending civil litigation related to the misuse of the federal NSA IDR system; and the volume of claims introduced by private equity-backed provider groups. WSHA submitted comments supporting extension of the BBPA process given the federal challenges.  

The state’s BBPA dispute resolution process applies to state-regulated carriers (individual and small group) as well as self-funded groups that have elected to participate in the BBPA. The BBPA process also applies to ground ambulance and certain emergency behavioral health services that are not included under the federal No Surprises Act. For claims that are subject to both the BBPA and the NSA, a facility or provider can use either dispute resolution process. More information is on the OIC Website. (Andrew Busz, [email protected].)