Committee hears staff briefing on Medicaid post-acute network standards; hospitals and insurers urge standards to reduce discharge delays

Chris Blake, staff for the House Health Care and Wellness Committee, summarized engrossed Senate Bill 5124, saying the bill directs the Health Care Authority to adopt network adequacy standards for nursing homes and inpatient rehabilitation facilities and to consider factors such as keeping care local, provider availability in regional service areas, timeliness of care and federal Medicaid requirements. Blake noted the standards must be adopted by 01/01/2028 and MCOs must meet requirements by 07/01/2028.

Megan Morris, committee staff, noted a fiscal note is in the electronic bill book and that total fiscal impacts are indeterminate because expanding networks will likely increase provider payments and per‑member per‑month costs for managed care organizations; she identified modest administrative cost estimates for rulemaking and IT updates.

In public testimony, Katie Collin (Washington State Hospital Association) said the bill addresses complex discharge issues where "single case agreements" are used instead of network standards and described the high cost and poor outcomes of prolonged hospital stays: "The hospital is, believe it or not, not the place you want to be when you're ready to be discharged. It's upwards of thousand $1,000 a day." Alex Dilley, government-relations analyst at MultiCare, testified that single case agreements can take days to over a week to arrange and that delayed placement into skilled care drives avoidable days and harms recovery.

Committee members asked staff and analysts clarifying questions about fiscal impacts and implementation timing. No vote was taken; staff and witnesses said stakeholder feedback would be part of HCA's rulemaking process.