Senate Bill 6293 amends existing workers’ compensation law (RCW 49.17.243, RCW 51.36.010, and references RCW 51.36.060), adds at least one new section to chapter 51.36 RCW, and creates a time-limited pilot program. The bill is primarily administrative and programmatic: it changes who may receive grants from the medical aid fund and how those funds must be distributed, revises standards and procedures for a department-run health care provider network, establishes certification and oversight for “centers for occupational health and education,” and creates a pilot to expand access to evidence-based care for posttraumatic stress disorder (PTSD) as an occupational disease. These are statutory changes to existing law plus the addition of new statutory sections rather than creation of new crimes or criminal penalties. On health care delivery and provider oversight, the bill requires the department to set minimum provider standards, create a network with a second tier based on demonstrated occupational health best practices, accept provider applications as contracts, adopt credentialing and removal criteria (including possible permanent removal for patterns of low-quality care), and develop financial and nonfinancial incentives for certified centers and second-tier providers. It limits nonnetwork care to an initial office or emergency visit once the network is available locally, requires payment for initial prescription drugs per the department fee schedule for state fund claims, and specifies treatment-duration limits with a process for advance written authorization by the supervisor of industrial insurance for continued treatment in certain cases. The department may authorize inoculation after probable occupational exposure and must report annually on network and center implementation for a specified period. The bill directs the department to establish additional centers focused on the first 12 weeks of care after injury, to certify and decertify centers using listed criteria, to develop electronic quality tracking and provider feedback, and to design a PTSD pilot that can authorize limited pre-adjudication mental health evaluation and treatment sessions and allow agreements with qualified providers. It reallocates medical aid fund grant uses, requiring minimum shares for return-to-work projects, small-business projects, and prevention projects, and permits use of some return-to-work funds for workplace behavioral health programs targeting occupations at high risk of PTSD from repetitive trauma exposure. The act authorizes rulemaking, requires self-insurer reporting for pilot claims on request, makes certain pilot provisions supersede conflicting statutes during the pilot, sets several effective and expiration dates (most of the act effective July 1, 2026; section 2 expires June 30, 2027; section 3 effective June 30, 2027; a report due July 1, 2030; one section expires December 31, 2030), and requires a director’s recommendations by July 1, 2030. Some specific text and cross-referenced sections (including full language of subsection (5), section 5, and the actual amended text of RCW 51.36.060) were not included in the extracted material, so certain procedural and program details remain unspecified here.

If enacted, the bill directs L&I to reallocate medical aid fund grants toward workplace safety, return-to-work, and small-business projects with minimum set-asides (at least 25% for return-to-work, 25% for small-business projects, and 50% for prevention projects) and explicitly allows funding for workplace behavioral health programs targeting PTSD-risk occupations. It also requires L&I to expand and certify centers for occupational health that concentrate resources in the first 12 weeks after injury, create a second tier of vetted network providers with financial and nonfinancial incentives, enforce benchmark quality measures (with the ability to remove low-performing providers), limit nonnetwork care to an initial visit once a network exists locally, and authorize pre-adjudication PTSD care limited to a diagnostic interview or evaluation plus 11 sessions within 90 days (with possible additional sessions later). Injured workers should see faster, more standardized access to evidence-based occupational care and some early mental health treatment; providers will face stricter credentialing, reporting, and quality oversight; and employers and self-insurers may access or be subject to new grants, utilization review, and reporting requirements. Practically, the department will take on new rulemaking, certification, tracking, incentive, and reporting duties and likely add administrative costs to implement the network, centers, and PTSD pilot; self-insurers must produce pilot claim reports on request and participate in utilization review, creating additional administrative burden. Providers may incur costs to meet network or center standards and risk removal for patterns of low-quality care, while nonnetwork providers will have limited reimbursement options for initial visits. Several important implementation details are missing from the extracted text—including full pilot payment rules for rejected claims, complete treatment-duration provisions, and some cross-referenced sections—so the exact funding flows, liability shifts, and long-term cost impacts remain uncertain.