Traditional health/medicaid

AN ACT Relating to medicaid coverage for traditional health care 1
practices; reenacting and amending RCW 43.71B.010; and adding a new 2
section to chapter 43.71B RCW. 3
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:4
Sec. 1. RCW 43.71B.010 and 2020 c 256 s 102 are each reenacted 5
and amended to read as follows: 6
The definitions in this section apply throughout this chapter 7
unless the context clearly requires otherwise. 8
(1) "Advisory council" means the governor's Indian health 9
advisory council established in RCW 43.71B.020. 10
(2) "Advisory plan" means the plan described in RCW 43.71B.030.11
(3) "American Indian" or "Alaska Native" means any individual who 12
is: (a) A member of a federally recognized tribe; or (b) eligible for 13
the Indian health service. 14
(4) "Authority" means the health care authority.15
(5) "Board" means the northwest Portland area Indian health 16
board, an Oregon nonprofit corporation wholly controlled by the 17
tribes in the states of Idaho, Oregon, and Washington.18
(6) "Commission" means the American Indian health commission for 19
Washington state, a Washington nonprofit corporation wholly 20
controlled by the tribes and urban Indian organizations in the state.21
H-0761.1
HOUSE BILL 1583
State of Washington 69th Legislature 2025 Regular Session
By Representatives Lekanoff, Wylie, Stearns, Macri, Parshley, Doglio,
Pollet, Reed, Kloba, and Davis
Read first time 01/24/25. Referred to Committee on Health Care &
Wellness.
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(7) "Community health aide" means a tribal community health 1
provider certified by a community health aide program of the Indian 2
health service or one or more tribes or tribal organizations 3
consistent with the provisions of 25 U.S.C. Sec. 1616l, who can 4
perform a wide range of duties within the provider's scope of 5
certified practice in health programs of a tribe, tribal 6
organization, Indian health service facility, or urban Indian 7
organization to improve access to culturally appropriate, quality 8
care for American Indians and Alaska Natives and their families and 9
communities, including but not limited to community health aides, 10
community health practitioners, behavioral health aides, behavioral 11
health practitioners, dental health aides, and dental health aide 12
therapists. 13
(8) "Community health aide program" means a community health aide 14
certification board for the state consistent with 25 U.S.C. Sec. 15
1616l and the training programs and certification requirements 16
established thereunder. 17
(9) "Fee-for-service" means the state's medicaid program for 18
which payments are made under the state plan, without a managed care 19
entity, in accordance with the fee-for-service payment methodology.20
(10) "Historical trauma" means situations where a community 21
experienced traumatic events, the events generated high levels of 22
collective distress, and the events were perpetuated by outsiders 23
with a destructive or genocidal intent. 24
(11) "Indian health care provider" means a health care program 25
operated by the Indian health service or by a tribe, tribal 26
organization, or urban Indian organization as those terms are defined 27
in 25 U.S.C. Sec. 1603. 28
(12) "Indian health service" means the federal agency within the 29
United States department of health and human services.30
(13) "New state savings" means the savings to the state general 31
fund that are achieved as a result of the centers for medicare and 32
medicaid services state health official letter 16-002 and related 33
guidance, calculated as the difference between (a) medicaid payments 34
received from the centers for medicare and medicaid services based on 35
the one hundred percent federal medical assistance percentage; and 36
(b) medicaid payments received from the centers for medicare and 37
medicaid services based on the federal medical assistance percentage 38
that would apply in the absence of state health official letter 39
16-002 and related guidance. 40
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(14) "Reinvestment account" means the Indian health improvement 1
reinvestment account created in RCW 43.71B.040. 2
(15) "Reinvestment committee" means the Indian health improvement 3
reinvestment committee established in RCW 43.71B.020(4).4
(16) "Traditional health care practices" means the sum total of 5
the knowledge, skill, and practices based on the theories, beliefs, 6
and experiences indigenous to different cultures, whether explicable 7
or not, used in the maintenance of health as well as in the 8
prevention, diagnosis, improvement, or treatment of physical and 9
mental illness.10
(17) "Tribal organization" has the meaning set forth in 25 U.S.C. 11
Sec. 5304. 12
(((17))) (18) "Tribally operated facility" means a health care 13
facility operated by one or more tribes or tribal organizations to 14
provide specialty services, including but not limited to evaluation 15
and treatment services, secure detox services, inpatient psychiatric 16
services, nursing home services, and residential substance use 17
disorder services. 18
(((18))) (19) "Tribe" means any Indian tribe, band, nation, or 19
other organized group or community, including any Alaska Native 20
village or group or regional or village corporation as defined in or 21
established pursuant to the Alaska Native claims settlement act (43 22
U.S.C. Sec. 1601 et seq.) which is recognized as eligible for the 23
special programs and services provided by the United States to 24
Indians because of their status as Indians. 25
(((19))) (20) "Urban Indian" means any individual who resides in 26
an urban center and is: (a) A member of a tribe terminated since 1940 27
and those tribes recognized now or in the future by the state in 28
which they reside, or who is a descendant, in the first or second 29
degree, of any such member; (b) an Eskimo or Aleut or other Alaska 30
Native; (c) considered by the secretary of the interior to be an 31
Indian for any purpose; or (d) considered by the United States 32
secretary of health and human services to be an Indian for purposes 33
of eligibility for Indian health services, including as a California 34
Indian, Eskimo, Aleut, or other Alaska Native. 35
(((20))) (21) "Urban Indian organization" means an urban Indian 36
organization, as defined by 25 U.S.C. Sec. 1603. 37
NEW SECTION. Sec. 2. A new section is added to chapter 43.71B 38
RCW to read as follows: 39
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The authority shall apply, no later than September 1, 2025, for a 1
waiver from the centers for medicare and medicaid services under 2
section 1115 (a) of the social security act to provide expenditure 3
authority for coverage of traditional health care practices. Upon 4
approval from the centers for medicare and medicaid services, the 5
authority shall provide coverage, in accordance with centers for 6
medicare and medicaid services requirements, for traditional health 7
care practices received through Indian health service facilities or 8
facilities operated by tribes or tribal organizations under the 9
Indian self-determination and education assistance act. Coverage of 10
these traditional health care practices must be available to medicaid 11
beneficiaries who are able to receive services delivered by or 12
through these facilities. 13
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