This bill amends RCW 74.09.520 to specify what “medical assistance” may include and to add and change coverage, payment, and procedural requirements for the state medical assistance program. It lists many covered services (hospital, lab, nursing facility, physician services including prescribed medication and birth control instruction, home health, private duty nursing, dental, therapies, prescribed drugs, prosthetics, eyeglasses, personal care, hospice, preventive and rehabilitative services, and certain school-based services) and says the authority may not cut off prescription medications, oxygen, respiratory services, or other life‑sustaining medical services or supplies. Routine foot care and non‑Title XIX‑mandated dental services are excluded unless specifically appropriated. The bill creates new coverage and procedural requirements rather than criminal penalties. It requires the department to adopt rules so Title XIX personal care services conform to federal regulations, to assess functional disability and allocate personal care benefits by assessed need and available funding with priority for greatest need, and to allow contracting with area agencies on aging and federally recognized tribes. It requires screening and provider payment policies (subject to appropriation) for autism/developmental delays, youth depression (ages 12–18), and maternal depression (mothers of children up to six months) on specified dates, and it requires reimbursement for certain mental health assessment and diagnosis services for children birth through five (including up to five intake/assessment sessions, home/community assessments with travel reimbursement, and use of the DC:0-5 diagnostic classification). It requires coverage for specific noninvasive preventive colorectal cancer screening tests and follow‑up colonoscopies (effective January 1, 2024). It also requires payment rules for hospital days when a Medicaid patient does not meet acute criteria but cannot be discharged for lack of placement and requires MCO administrative and review processes. The bill adds a new durable medical equipment coverage requirement effective January 1, 2026, requiring coverage of seizure detection devices that are FDA‑approved and meet specified clinical appropriateness conditions, defines “durable medical equipment” and “seizure detection device,” requires full coverage of device costs and related services/subscriptions with subscription reimbursement set at 100% of the authority’s telemonitoring monthly remote monitoring rate, and requires a biennial review of covered devices. Affected entities include the state authority and department named in statute, Medicaid managed care organizations, hospitals and long‑term care settings, providers, beneficiaries (including full‑benefit dual eligibles), caregivers who would receive device alerts, and others. The extracted text does not identify the specific agency names for “authority” and “department,” does not include the existing list of covered seizure detection devices or dollar amounts for reimbursement rates, and does not provide the detailed rule language or procedures for implementation or for the cross‑referenced RCW provisions.

If enacted, low-income Washington residents covered by medical assistance would likely get broader access to services and equipment: preventive colorectal screenings and follow-up colonoscopies are required, and by January 1, 2026 federally approved seizure detection devices would be covered as durable medical equipment with full device costs and related subscriptions paid at the program’s telemonitoring rate. Hospitals would be paid for days when Medicaid patients no longer meet acute criteria but cannot leave because of lack of placement, which may reduce uncompensated care and require hospitals to use swing or skilled nursing beds when available; Medicaid managed care plans must set up administrative and review processes, and providers would have new screening and assessment payment responsibilities for autism, youth and maternal depression, and early childhood mental health assessments (some subject to appropriations). These changes shift more direct costs and ongoing payment obligations onto the Medicaid program/authority, and increase administrative duties for the authority, MCOs, hospitals and providers; caregivers may receive device alerts and services funded by the program. Key implementation details that affect real cost and rollout remain unspecified in the extract — the specific agency names, exact reimbursement dollar rates, the current list of covered seizure devices, and precise criteria for medical appropriateness and biennial review — so the net fiscal impact and timing depend on those unresolved details and on whether the legislature provides the necessary appropriations.