Making payments for services provided by a rural emergency hospital subject to appropriation.

HB 2488 changes how Washington state pays rural emergency hospitals for services provided to Medicaid patients. It makes these payments dependent on annual state budget appropriations rather than automatic funding. This directly affects rural hospitals federally designated as "rural emergency hospitals" (not critical access hospitals). The bill replaces previous automatic payment rules with a system requiring yearly legislative funding approval for these hospitals to receive Medicaid reimbursement. The change applies to all services provided to Medicaid beneficiaries, regardless of their managed care enrollment.