This bill reenacts and amends RCW 43.71B.010 and adds a new section to chapter 43.71B RCW that requires the Washington State Health Care Authority to apply, by September 1, 2025, for a Centers for Medicare and Medicaid Services (CMS) section 1115(a) waiver to obtain expenditure authority for coverage of traditional health care practices. If CMS approves the waiver, the authority must provide coverage, consistent with CMS requirements, for traditional health care practices received through Indian Health Service facilities, tribally operated facilities under the Indian Self-Determination and Education Assistance Act, or urban Indian organization facilities under Title V of the Indian Health Care Improvement Act, and that coverage must be available to Medicaid beneficiaries able to receive services through those facilities. This is a procedural change creating a required federal waiver application and conditioning a potential expansion of Medicaid coverage on CMS approval; it does not itself set specific reimbursement rates, billing mechanisms, or provider credentialing. The bill also (re)defines terms in RCW 43.71B.010 related to the change, including “traditional health care practices,” “community health aide,” “Indian health care provider,” and other tribal and urban Indian terms, and references the Indian health improvement reinvestment account and related advisory bodies in chapter 43.71B. The act is null and void unless specific funding referencing this act is included in the omnibus appropriations act by June 30, 2025. Important implementation details and CMS requirements for coverage, the content of CMS guidance referenced, and the full text of the other cited sections of chapter 43.71B are not included in the provided text.

If the Legislature provides the specified funding and CMS approves the waiver the Health Care Authority must seek, Medicaid coverage would likely be expanded to pay for traditional health care practices when they are delivered at Indian Health Service sites, tribally operated facilities, or urban Indian organizations. That would probably increase access for Medicaid beneficiaries who use those sites and could bring additional federal Medicaid dollars to those tribal and urban providers, while requiring the Health Care Authority to prepare and run the waiver and follow CMS conditions for coverage. The groups most affected are the Health Care Authority (which must apply for and implement the waiver and absorb administrative costs and responsibilities), tribes and tribal health programs, the Indian Health Service, urban Indian organizations (which could see more insured patients and revenue), and Medicaid beneficiaries served at those facilities (who may gain covered services). The plan’s success and budget impact hinge on CMS approval and on the Legislature providing the required funding by June 30, 2025; the bill leaves important details—what specific traditional practices will be covered, payment rates, billing and credentialing rules, and the exact federal matching calculations—undetermined, so actual costs, timelines, and the scope of coverage are uncertain.