House Bill 2385 creates a Medicaid access program and amends RCW 74.76.020 and RCW 74.76.050 (and an uncodified 2025 provision) to establish conditions, timelines, and procedures for implementing that program. The bill requires the Washington State Health Care Authority to submit any necessary state plan amendments or waiver requests to the Centers for Medicare and Medicaid Services by September 1, 2030, and makes assessment, collection, and disbursement of program funds conditional on final CMS approval of those amendments or waivers, amendment of contracts with managed care organizations as necessary, and certification by the Office of Financial Management that appropriations fully support the rates for the upcoming fiscal year. If those conditions are met, the bill directs uniform increases to professional services rates for a listed set of services by January 1 of the second plan year after the conditions are met, with the specific percentage tied to available funds in the account created in RCW 74.76.040, and requires that by January 1 of the third plan year and annually thereafter rates be adjusted using the most recently published Medicare Economic Index. Beginning January 1 of the third plan year after the conditions are met, and by January 1 in each of the two subsequent plan years, the Health Care Authority must study the impact of those rate increases on Medicaid access and report findings to the Legislature’s fiscal and health committees, disaggregating managed care and fee-for-service data. The act includes an expiration provision: if CMS has not given final approval by January 1, 2032, the act will expire and the Health Care Authority must provide written notice of that expiration to affected parties and legislative offices. The bill defines key terms used in these provisions (for example, "authority" means the Washington State Health Care Authority, and references to CMS and OFM), and affects the Health Care Authority, CMS, OFM, managed care organizations, Medicaid enrollees, fee-for-service Medicaid, and providers of specified professional services. Important context is missing from the provided text: the bill excerpt does not define "plan year," does not state the specific percentage increase for rates, does not provide details of the account in RCW 74.76.040 or the current rates or methodology in RCW 74.76.030, and may rely on other uncodified or prior sections not included here.

If enacted, the bill would launch a Medicaid access program that is likely to raise what the state pays many outpatient and hospital-based providers (anesthesia, surgery, office visits, maternity, behavioral health, etc.) toward Medicare levels. Provider payments would be increased in stages once the Health Care Authority gets federal approval and OFM confirms the state has the money; those increases would be based on available prior-year collections in a designated account and then indexed annually to the Medicare Economic Index. Managed care organizations will need contract amendments and could see their payment flows and obligations change, the Health Care Authority will take on new responsibilities to request federal waivers, submit state plan changes, and report studies to the Legislature, and OFM must certify the funding—so state budgets and MCO finances will be the main places costs and responsibilities shift. Key deadlines and risks matter: the authority must submit required federal requests by September 1, 2030 and the whole act expires if CMS has not given final approval by January 1, 2032, so nothing happens until federal sign‑off and OFM certification occur. Important details that determine how big the payment changes will be are missing here—the bill does not specify the exact percentage increases, the length or definition of a “plan year,” or the current account balance and methodology in RCW 74.76.040 and RCW 74.76.030—so the size and timing of actual payments and fiscal impacts remain uncertain.