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Committee hears bill to set Medicaid network standards for post-acute care to speed discharges
Summary
House Health Care & Wellness Committee reviewed Substitute Senate Bill 5124, which would require the Health Care Authority to adopt network adequacy standards for post-acute services including skilled nursing and inpatient rehabilitation to improve timely access and reduce hospital discharge delays.
Substitute Senate Bill 5124, which would require the Health Care Authority to adopt network adequacy standards for post-acute services for Medicaid managed care, was presented to the Washington House Health Care & Wellness Committee during a public hearing.
The bill, explained by Kim Weidner, staff to the committee, directs the Health Care Authority to develop standards for skilled nursing facilities and inpatient rehabilitation facilities by Jan. 1, 2027, and to consider the Washington Medicaid principle of keeping care local, regional provider availability and timeliness of care. It would also require managed care organization contracts effective on or after July 1, 2027, to meet the new standards and would direct the Health Care Authority to monitor and periodically report the share of services provided by contracted and nonparticipating providers by county for each Medicaid managed care organization.
Why it matters: Advocates and health system representatives told the committee that predictable, timely placement into post-acute settings can improve patient outcomes and free hospital beds. Katie Cohen of the State Hospital Association said patients “stuck” in hospitals awaiting placement receive poorer outcomes and that prolonged hospital stays are expensive, saying it can be “up to $1,000 a day just to hold a patient there.” She and other witnesses urged network standards to reduce reliance on single-case agreements and shorten discharge delays.
Details and record: Federal Medicaid managed care rules require states to adopt network adequacy standards for certain provider types; SB 5124 would extend that focus to post-acute care and ask the Health Care Authority to obtain stakeholder feedback during standards development. Staff said the standards must account for access across counties and allow reporting on contracted versus nonparticipating providers. Committee staff answered procedural questions and the hearing concluded with no immediate vote on the bill.
Next steps: The committee suspended the hearing and proceeded to other bills. No formal committee action on SB 5124 was recorded in the transcript during this hearing.
