Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
HB 1583
Brief Description: Concerning medicaid coverage for traditional health care practices.
Sponsors: Representatives Lekanoff, Wylie, Stearns, Macri, Parshley, Doglio, Pollet, Reed, Kloba and Davis.
Brief Summary of Bill
  • Requires the Health Care Authority (HCA) to apply for a Section 1115 waiver from the Centers for Medicare and Medicaid Services (CMS) to provide coverage of traditional health care practices.
  • Requires the HCA to provide coverage, upon approval from the CMS, for traditional health care practices received through the Indian Health Service facilities or facilities operated by Tribes or Tribal Organizations.
Hearing Date: 2/4/25
Staff: Kim Weidenaar (786-7120).
Background:

Medicaid Reimbursement for Services for American Indians and Alaska Natives.?

The Indian Health Service (IHS), part of the federal Department of Health and Human Services, is the federal agency with primary responsibility for fulfilling the United States' trust obligation to provide health care for American Indians and Alaska Natives. ?Twenty-seven of Washington's 29 federally recognized tribes operate their own health care clinics or have a health clinic operated by IHS on their lands. ?In addition, there are two urban Indian health programs in Seattle and Spokane that provide care to urban American Indians and Alaska Natives. ?Under Medicaid, the federal government pays 100 percent of the Federal Medical Assistance Percentage for American Indians and Alaska Natives for covered services received through IHS facilities and tribal health care facilities, and Medicaid services provided by non-IHS or non-Indian health providers through a care coordination agreement.

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Section 1115 Waivers for Traditional Health Care Practices.

On October 16, 2024, the Centers for Medicare & Medicaid Services (CMS) approved Section 1115 waivers in four states, Arizona, California, New Mexico, and Oregon, that allow state Medicaid agencies to cover American Indian and Alaska Native traditional health care practices.? Traditional health care practices have previously been offered at some IHS, Tribal, and urban Indian organization health care facilities, but have typically been paid for through a combination of IHS appropriations, Tribal revenues, and grant funding. ?The waivers in Arizona, New Mexico, and Oregon allow anyone covered by Medicaid and eligible for care through the IHS to receive traditional health care services.?
Summary of Bill:

By September 1, 2025, the HCA must apply for a waiver from the CMS under Section 1115(a) of the Social Security Act to provide expenditure authority for coverage of traditional health care practices. ?Upon approval from the CMS, the HCA must provide coverage, for traditional health care practices received through Indian Health Service facilities or facilities operated by Tribes or Tribal Organizations.? Coverage of these traditional health care practices must be available to Medicaid beneficiaries who are able to receive services delivered by or through these facilities.

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"Traditional health care practices" are the sum total of the knowledge, skill, and practices based on the theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement, or treatment of physical and mental illness.
Appropriation: None.
Fiscal Note: Requested on January 29, 2025.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.