This bill amends existing law to allow and require coverage and reimbursement for ground ambulance transports to facilities other than hospital emergency departments (examples listed include urgent care clinics, mental health facilities, and substance use disorder programs) when authorized by regional emergency medical services and trauma care plans. It amends RCW 18.73.280 to authorize such transports, requires health carriers under RCW 48.43.121 to cover ground ambulance transport to behavioral health emergency services for enrollees with an emergency medical condition for plans issued or renewed on or after January 1, 2025, and to cover ground ambulance transport to other non‑emergency department facilities for plans issued or renewed on or after January 1, 2026. A new section requires employee health plans under chapter 41.05 RCW issued or renewed on or after January 1, 2026, to provide the same coverage. Coverage may be subject to applicable in‑network copayments, coinsurance, and deductibles. The bill also amends RCW 74.09.330 to require the relevant authority to develop a reimbursement methodology for medical assistance (Medicaid) when ambulance services transport enrollees to facilities other than emergency departments. It revises definitions and regional planning requirements in RCW 70.168 (including RCW 70.168.015 and RCW 70.168.100) to require regional emergency medical services and trauma care councils to identify procedures allowing appropriate transport to non‑emergency department facilities, to include prehospital patient care protocols in plans, and to incorporate verification of prehospital providers into licensure. The bill extends statutory liability protection for acts or omissions committed in good faith while rendering emergency medical services to include transports to alternative facilities carried out in accordance with adopted alternative facility procedures; the liability protection does not apply to gross negligence or willful or wanton misconduct and applies only within the scope of emergency medical procedures. Affected parties expressly include ambulance services, health carriers, state employee health plans and their enrollees, behavioral health emergency services providers, medical assistance enrollees, the Department of Health, regional and local EMS and trauma councils, emergency communication centers, EMS medical program directors, designated hospitals and facilities, and urgent care, mental health, and substance use disorder programs. The extract omits the full text of RCW 18.71.210 that is listed as reenacted and amended, the full text of RCW 70.168.100 and related alternative facility procedures, and it does not identify which entity is referenced as “the authority” for developing the Medicaid reimbursement methodology.

Ambulance crews will be able to take patients to places other than hospital emergency departments—like urgent care, mental health crisis centers, or substance use treatment programs—under regional plans, and private insurers must start paying for those ground transports to behavioral health destinations beginning January 1, 2025 and to other non‑ER facilities beginning January 1, 2026. For patients this likely means fewer denials or delays when a prudent layperson believes an emergency exists and potentially fewer surprise out‑of‑pocket barriers, although standard in‑network copays, coinsurance, and deductibles can still apply; insurers and employer health plans will face new claim costs as a result. Regional EMS councils must write protocols and budgets to guide these alternative transports, ambulance providers gain clearer authorization and limited liability protection when they follow those protocols, and Medicaid will get a new reimbursement methodology that will change payment levels for transporting Medicaid enrollees to non‑ER facilities — affecting ambulance revenues and state Medicaid spending. Key implementation details are missing here, including who exactly must set the Medicaid payment rates and the specific criteria and procedures for qualifying alternative facilities, so some operational and cost impacts remain uncertain.