This bill modifies existing law by establishing an ambulance quality assurance fee program and adding an annual add-on to the Medicaid fee‑for‑service payment schedule to increase reimbursement for emergency ground ambulance transports. The add-on amount is set each year by the Washington Health Care Authority and is calculated as the available fee amount projected for the prior fiscal year divided by the total Medicaid emergency ambulance transports projected for the prior fiscal year. The increased payments are funded solely from proceeds of the quality assurance fee (and interest on those funds) and any resulting federal matching funds, and those proceeds must supplement, not supplant, existing funding for emergency ambulance transports. The bill amends RCW 74.70.060, 74.70.050, and 74.70.020. The bill defines key terms for the program: “emergency ambulance transport” means a transport when a patient receives needed emergency medical services en route to an appropriate medical facility and excludes transportation by passenger cars, taxicabs, litter vans, wheelchair vans, other public or private conveyances, and air ambulance providers; “fee‑for‑service payment schedule” is the payment rate without the add‑on; and “gross receipts” for emergency ambulance transports is total patient care revenue on a cash basis, including Medicaid, Medicare, commercial insurers, and other payers. The Health Care Authority is the implementing agency and the program applies to licensed ambulance transport providers who bill and receive patient care revenue for ground emergency ambulance transports, excluding specified public or governmental providers. The bill sets program mechanics and timelines: the authority may seek federal approval to implement time‑limited add‑on increases; it must assess a quarterly quality assurance fee to each provider based on the annual fee rate multiplied by the number of emergency transports provided in the second quarter preceding the assessed quarter; for state fiscal years July 1, 2022–June 30, 2026 the annual fee rate is calculated by a specified formula using projected aggregate fee schedule amounts, the state medical assistance percentage, and 90% of projected statewide transports; beginning July 1, 2026 the annual rate is the rate in effect July 4, 2025, with adjustment authority if the available fee amount and aggregate fee schedule amount differ by more than one percent. Providers must receive assessment notices and invoices at least 30 days before relevant deadlines, payments are due no earlier than 15 days after the quarter begins, interest and penalties apply under RCW 43.20B.695 for late fees, the authority may deduct unpaid fees and interest from Medicaid reimbursements after notice and assess a monthly penalty equal to the interest charge for each month past 60 days, and the authority may waive interest or penalties for undue financial hardship conditioned on an alternate payment schedule. Successor entities in mergers or acquisitions are responsible for outstanding fee obligations attributable to the predecessor. The bill references the ambulance transport fund and other RCW sections (including RCW 74.70.030 and RCW 74.70.040) but the content of those referenced sections and some historical redline text are not included in the extracted facts; the definition and program text appear to be incomplete in places in the source extracts. The bill identifier is S-3861.1 / Senate Bill 6102 and it was read for the first time on January 13, 2026.

If enacted, private ground ambulance companies that bill for emergency patient transports will be charged a new quarterly quality assurance fee based on the number of emergency transports they provided, and those collected fees (plus federal matching money) will be used to create an annual Medicaid fee‑for‑service add‑on to raise reimbursement rates for emergency ambulance transports. The Health Care Authority will calculate and adjust the add‑on and fee rates annually, must give providers advance notice and invoices, can assess interest and penalties or deduct unpaid fees from Medicaid payments after 60 days, and may waive penalties for documented hardship; entities that buy or merge with providers inherit any outstanding fee obligations. The groups most affected are private ambulance transport providers (public entities, tribes, and air ambulances are excluded); they will face new recurring costs tied to transport volume but may receive higher Medicaid payments that could offset those costs — whether a provider is better or worse off financially depends on the add‑on amount, the effective state medical assistance percentage, and federal matching that the authority projects. Important implementation details and the precise dollar impact are unclear from the provided text because several referenced RCW provisions and some projection inputs are not included.