WA SB5955

Prohibits the Washington Health Care Authority from contracting with managed care organizations or other financial risk-bearing entities for Medicaid services beginning July 1, 2026, with all existing MCO contracts terminating by December 31, 2026

Transitions Medicaid to a managed fee-for-service model where providers are paid directly by the state at Medicare rates, with care coordination funded separately through a newly created Care Coordination Fund account

Allows the authority to contract with administrative services organizations for non-risk functions like claims processing, prior authorization review, and customer service, but explicitly prohibits AI-generated denials of care

Requires local health jurisdictions to serve as oversight bodies meeting quarterly to monitor community health needs, identify service gaps, and report findings to the authority and county councils

Mandates full implementation by January 1, 2027, with the authority required to submit a detailed budget and implementation timeline by December 1, 2026, and annual reports to the legislature thereafter