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Committee hears request to delay state adoption of ASAM fourth edition for SUD treatment
Summary
Senate Bill 5361 would delay adoption of the American Society of Addiction Medicine's fourth edition criteria for substance use disorder treatment from Jan. 1, 2026, to Jan. 1, 2028; sponsors said the delay would save state General Fund dollars and give providers time to prepare.
The Senate Health and Long Term Care Committee held a public hearing Jan. 28 on Senate Bill 5361, a request bill from the Office of Financial Management and prime-sponsored by Sen. Manka Dhingra, to delay the adoption of the American Society of Addiction Medicine (ASAM) fourth edition criteria for substance use disorder (SUD) treatment for two years.
Committee staff described the background: Washington law directed the Health Care Authority (HCA) and the Office of the Insurance Commissioner (OIC) to use the ASAM criteria as a single, uniform set of medical-necessity standards for SUD treatment. The ASAM 4th edition revised levels of care and recommends higher-intensity services for certain patients, prompting HCA's analysis of implementation costs.
HCA and OFM estimated total costs to implement ASAM-4 at about $27.5 million statewide; about two-thirds of that would be paid with new federal Medicaid dollars, leaving a net state General Fund impact of approximately $10.4 million on the next biennial budget, staff told the committee. The bill would delay the effective adoption date from Jan. 1, 2026, to Jan. 1, 2028, giving time for provider education, record and coding changes, hiring and credentialing, and HCA training capacity.
Sen. Manka Dhingra, sponsor of the OFM request bill, said the policy is sound and should be adopted eventually but that the state faces a tight budget now. "I still hold that that is the right policy ... but everything comes with a cost and so let's keep the good policy but let's figure out how to pay for it later on," Dhingra told the panel.
Provider testimony reflected concern about clinical changes in ASAM-4. Joe Barrett, CEO of Key Recovery, a 107-bed ASAM 3.3 long-term residential provider in King County, said the fourth edition effectively eliminates long-term residential treatment as defined previously and does not offer replacement options for high-need patients. "For these patients, long term residential treatment can literally be the end of the line," Barrett said, urging the committee to delay implementation to preserve access to long-term residential SUD services.
Office of Financial Management legislative affairs director Sherry Sawyer testified in support of the OFM request, reiterating that the proposal appears in the governor's proposed operating budget and aims to avoid immediate additional expenditures.
The committee accepted public testimony and closed the hearing. No committee vote was taken during the hearing.
