The bill creates a new section in chapter 74.09 RCW that requires provider payment for rapid whole genome sequencing, including pretest and posttest counseling by an appropriate health care provider, for certain enrollees in medical assistance programs. Coverage is limited to enrollees up to one year of age who are receiving inpatient hospital services in an intensive care unit, neonatal unit, or high acuity pediatric care unit, and applies beginning January 1, 2026. Eligibility requires that the enrollee’s medical condition is unknown with specified clinical features, alternate causes have been considered and ruled out, and a timely molecular diagnosis is necessary to guide clinical decision making and may aid treatment or management. The bill defines “rapid whole genome sequencing” as sequencing of the entire human genome, including coding and noncoding regions and mitochondrial DNA, with a final report delivered in less than 14 days; it includes patient-only, duo, and trio sequencing and associated analysis and reporting. As a procedural and payment change, the bill requires separate payment for these services even under capitated or bundled payment arrangements unless the payer and provider have negotiated an increased capitated or bundled rate to include rapid sequencing. It does not specify payment rates, administrative procedures, the specific RCW section number, which agency “the authority” refers to, or the meaning of “appropriate health care provider,” and broader implementation details, exclusions, and appeals processes are not provided in the extracted text.

If enacted, starting January 1, 2026 Medicaid programs would be required to pay for rapid whole genome sequencing (including pretest and posttest counseling) for babies under one year old who are in intensive care, neonatal, or high-acuity pediatric units when their condition is unexplained, certain clinical features are present, other causes have been ruled out, and a quick genetic diagnosis could change care. The sequencing must cover the whole genome (including mitochondrial DNA), can be done on the patient alone or with parents, and must produce a final report in under 14 days, so hospitals and clinical labs that provide rapid testing are likely to see more requests and need to meet quick turnaround times. The biggest impacts fall on managed care organizations and any providers paid under capitated or bundled arrangements, because payers must pay for these tests separately unless they negotiate higher capitation or bundle rates to include them; that means near-term increases in claim costs or the need to renegotiate contracts. Ordering clinicians and hospitals will have a new funded option for making rapid genetic diagnoses for eligible infants, but important implementation details are missing: the bill does not say which agency is the enforcing authority, who counts as an “appropriate health care provider,” what payment rates or administrative procedures will be, or where the funding comes from, so actual costs and how quickly this will be put into practice remain uncertain.