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

This bill changes how Washington state funds rural emergency hospitals. It requires that payments for services provided by rural emergency hospitals (designated by federal Medicare/Medicaid) must be approved each year through the state budget, rather than being automatically funded. This affects hospitals meeting federal rural emergency hospital criteria, including those that previously received automatic payments. The change applies to all medical assistance program services provided by these hospitals, regardless of patient enrollment in managed care. The bill does not alter existing payment rates but shifts the funding mechanism to annual appropriations.