WA SB5372

Creates the Medicaid Access Program to increase Medicaid professional services reimbursement rates to match Medicare rates as of December 31, 2024, covering services such as anesthesia, emergency room, maternity, surgery, and behavioral health

Imposes annual covered lives assessments beginning January 1st following federal approval: $18 per member per month for Medicaid managed care organizations and $0.50 per member per month for health carriers, with a 36-to-1 ratio between the two groups

Assessments are capped at the first 3,000,000 member months per organization, with funds deposited into a new Medicaid Access Program Account in the state treasury

Requires the Washington State Health Care Authority to submit necessary state plan amendments or waiver requests to the Centers for Medicare and Medicaid Services by September 1, 2025

The act expires if CMS does not provide final approval by January 1, 2027, and provisions are non-severable meaning if any portion is invalidated, the entire act becomes ineffective