WA SB6194

Rural hospitals located on federally recognized Indian reservations that receive critical access hospital designation from CMS on or after January 1, 2026, become eligible for Medicaid cost-based reimbursement payments

Rural hospitals on reservations that do not receive critical access hospital designation on or after January 1, 2026, may still receive cost-based Medicaid payments if they maintain no more than 25 inpatient beds (excluding psychiatric unit beds)

Payments apply regardless of whether the Medicaid beneficiary is enrolled in managed care

The bill amends RCW 74.09.5225, which governs critical access hospital payment methodologies and includes provisions for the Washington rural health access preservation pilot program