This bill amends RCW 74.09.520 to enumerate the types of services that "medical assistance" may include and to add multiple coverage, payment, and administrative requirements. It states that the authority or department may not cut off prescription medications, oxygen, respiratory services, or other life‑sustaining medical supplies; specifies that routine foot care and certain dental services are excluded unless specifically appropriated; requires offering hospice services (per available funds) and allows, subject to appropriation, Medicare Part D copayment coverage for full‑benefit dual eligible beneficiaries. It requires coverage or provider payment for specified screenings and services on stated effective dates (universal autism/developmental delay screening effective Jan 1, 2016; annual youth depression screening and maternal depression screening effective Jan 1, 2018, subject to appropriations; required coverage for USPSTF A/B noninvasive colorectal cancer screening tests and follow‑up colonoscopies effective Jan 1, 2024) and authorizes reimbursable mental health assessment and diagnosis services for children birth through five years including use of the DC:0-5 diagnostic classification, up to five assessment sessions, and travel reimbursement for in‑home or community assessments. The amendment imposes procedural and payment rules: the department must adopt rules to ensure Title XIX personal care services conform to federal Medicaid requirements (including financial eligibility indexing, medical‑condition‑based assessments, and registered nurse review where required), design a means to assess functional disability levels for personal care, and prioritize funding reductions to those with greatest need. It requires contracts (or contracts with federally recognized tribes) with area agencies on aging for case management of certain home recipients, with competitive bidding or direct provision if no contractor is available. It requires hospitals to be paid for days when a Medicaid patient no longer meets acute inpatient criteria but cannot be discharged for lack of an appropriate placement, directs hospitals to use swing or skilled nursing beds first where appropriate, and directs the authority to adopt rules to calculate and pay such days and to require managed care organizations to establish uniform administrative and review processes. The authority must adopt a standardized definition and reporting mechanism for wait times for pediatric primary care and applied behavior analysis service codes by December 31, 2026; beginning with the fiscal year starting July 1, 2027, the authority may not reduce reimbursement rates for those service codes if the statewide average waitlist exceeds 30 days, and if overall appropriation authority is reduced the statute prescribes an ordered sequence for reductions (administrative costs first, then nonbargained executive salaries, then reimbursement rates), with any legislative rate increases for those codes to be applied as an additional layer on top of base rates. This is an amendment to existing law focusing on coverage expansions, benefit definitions, procedural rulemaking, contracting and payment mechanisms, and budgetary sequencing; it does not create new criminal penalties. Important context is missing from the extracted text: the specific identities of "the authority" and "the department" are not named here, the exact differences from the prior version of RCW 74.09.520 are not shown, key terms such as specific service code definitions and "average statewide waitlist" are not defined in this excerpt, and many provisions are subject to appropriations without stated funding amounts.

If enacted, Medicaid in Washington would be required to keep paying for a broad set of medically necessary services and could not terminate prescription medications, oxygen, respiratory supports, or other life‑sustaining supplies for enrollees. State agencies would need to tighten how they determine eligibility and need for in‑home personal care (including nurse review and a standardized disability assessment), expand or pay for certain early screenings and assessments for children and maternal and youth depression when the legislature provides funding, and pay hospitals for days when patients are medically ready to leave but no appropriate placement exists. Area agencies on aging, tribes, hospitals, pediatric and applied behavior analysis providers, and managed care plans would see changes in contracting, payment responsibilities, and documentation/reporting requirements, and some providers may get protected from rate cuts if statewide waitlists exceed 30 days starting in the 2027 fiscal year. How costs and responsibilities change is partly uncertain because the bill ties many new payments and protections to specific appropriations and leaves some key definitions and reporting rules to agency rulemaking. Agencies will likely need more staff or contracting capacity to do assessments, nurse reviews, case management and wait‑time reporting, and hospitals and post‑acute providers may see different payment patterns for delayed discharges; at the same time, the law creates a funding‑priority order for any agency budget cuts and requires legislative rate increases for pediatric primary care and ABA services to be added on top of base rates.