Text of WA HB 1072 (2026)

AN ACT Relating to preserving access to protected health care 1 services by requiring department of health review of certain health 2 care business transactions which could affect access to protected 3 health care services while balancing access to community health 4 services; giving authority to the department of health to approve, 5 approve with conditions or modifications, or deny health care 6 business transactions, and establishing the process and requirements 7 for such determination; giving authority to the attorney general to 8 enjoin qualifying health care business transactions not approved or 9 approved with conditions or modifications by the department of 10 health; and directing the collection of data and provision of 11 information, analysis, and reporting regarding access to protected 12 health care services; amending RCW 43.370.030; adding a new chapter 13 to Title 70 RCW; and providing effective dates. 14 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: 15 PART I 16 FINDINGS, INTENT, AND DEFINITIONS 17 NEW SECTION. Sec. 1. The legislature finds that protecting the 18 accessibility of reproductive health care, end-of-life care, and 19 gender-affirming care in communities across the state requires 20 H-0163.1 HOUSE BILL 1072 State of Washington 69th Legislature 2025 Regular Session By Representatives Walen, Leavitt, Reeves, and Berg Prefiled 12/16/24. p. 1 HB 1072 additional analysis and scrutiny. It is the intent of the legislature 1 to ensure that residents have access to these services in the 2 communities in which they live. In order to provide communities, 3 health care providers, and state regulators the information they need 4 to ensure adequate access to these protected services, the 5 legislature intends to update the statewide health resource strategy 6 to specifically include ongoing analysis of the availability of these 7 services. Additionally, the legislature intends to empower the 8 department of health to scrutinize health care transactions that 9 would directly affect access to care that is the subject of the 10 reproductive privacy act, care that is the subject of the death with 11 dignity act, and gender affirming health care. In considering the 12 effect of health care transactions, the legislature is also aware 13 that denial or delay of such transactions may lead to health care 14 service disruption or loss of critically important community health 15 care services including hospital care, emergency care, specialty 16 care, primary care, obstetric care, or other services. The 17 legislature intends that regulation of such transactions by the 18 department in order to protect access to these sensitive health care 19 services is additive and complementary to the existing powers given 20 to the attorney general to review transactions for anticompetitive 21 conduct and consumer harm. 22 NEW SECTION. Sec. 2. The definitions in this section apply 23 throughout this chapter unless the context clearly requires 24 otherwise. 25 (1) "Community health care services" means hospital care, 26 emergency care, specialty care, primary care, obstetric care, or 27 other health services important to the community. 28 (2) "Department" means the Washington state department of health. 29 (3) "Gender affirming health care" means care for an individual 30 to support and affirm the individual's gender identity. Gender 31 affirming treatment includes, but is not limited to, treatment for 32 gender dysphoria. Gender affirming health care can be prescribed to 33 two spirit, transgender, nonbinary, and other gender diverse 34 individuals. 35 (4) "Health care entity" means: 36 (a) Provider organizations; 37 (b) Hospitals; 38 (c) Health systems; or 39 p. 2 HB 1072 (d) Carriers or insurance holding company systems as defined in 1 RCW 48.31B.005. 2 (5) "Health care transaction" or "transaction" means a business 3 transaction by purchase, merger, or joint venture where one party is 4 a health care entity. 5 (6) "Health district" has the same meaning as in RCW 70.05.010. 6 (7) "Health system" means: 7 (a) A parent corporation of one or more hospitals and any entity 8 affiliated with such parent corporation through ownership or control; 9 or 10 (b) A hospital and any entity affiliated with such hospital 11 through ownership. 12 (8) "Hospital" means any entity that is licensed under chapter 13 70.41 or 71.12 RCW. 14 (9) "Person" means an individual, a trust or estate, a 15 partnership, a corporation including associations, limited liability 16 companies, joint stock companies, and insurance companies. 17 (10)(a) "Protected health care services" means: 18 (i) Reproductive services that are the subject of the 19 reproductive privacy act established pursuant to Initiative Measure 20 No. 120, approved November 5, 1991; 21 (ii) Death with dignity services that are the subject of the 22 Washington death with dignity act established pursuant to Initiative 23 Measure No. 1000, approved November 4, 2008; and 24 (iii) Gender affirming health care. 25 (b) Protected health care services may be provided virtually, on 26 demand, or in brick-and-mortar settings. 27 (11) "Provider" means a natural person who (a) has primary 28 responsibility for the care of a patient receiving protected health 29 care services within the person's scope of practice and (b) practices 30 a profession identified in RCW 18.130.040. 31 (12) "Provider organization" means a corporation, partnership, 32 business trust, association, or organized group of persons, whether 33 incorporated or not, which is in the business of health care delivery 34 or management and that represents seven or more health care providers 35 in contracting with carriers or third-party administrators for the 36 payments of health care services. A "provider organization" includes 37 physician organizations, physician-hospital organizations, 38 independent practice associations, provider networks, and accountable 39 care organizations. 40 p. 3 HB 1072 PART II 1 TRANSACTION APPLICATION AND REVIEW 2 NEW SECTION. Sec. 3. (1) A health care entity that provides 3 protected health care services may not engage in a health care 4 transaction which may as of the time of the transaction affect access 5 to protected health care services in one or more health districts 6 without the transaction first having received the approval of the 7 department under this chapter. 8 (2) Not less than 60 days prior to the effective date of a 9 transaction subject to this section, a party to the transaction must 10 submit an application to the department on forms provided by the 11 department. The forms provided by the department must require the 12 following: 13 (a) The name of the health care entities; 14 (b) A brief description of the transaction; 15 (c) A brief description of how protected health care services 16 will be unchanged, increased, limited, or reduced as a result of the 17 health care transaction, including the geographic areas affected; 18 (d) If applicable, a description of how the transaction will 19 promote access to community health care services; and 20 (e) The health entity's or entities' proposed plan to address any 21 reduction or limitation to access to protected health care services. 22 (3) The applications and all supporting documents submitted to 23 the department are considered public records for purposes of chapter 24 42.56 RCW. 25 (4) The department shall charge an application fee sufficient to 26 cover the costs of implementing this chapter. 27 NEW SECTION. Sec. 4. (1) The department shall determine if the 28 application required under section 3 of this act is complete for the 29 purposes of review. The department may find that an application is 30 incomplete if a question on the application form has not been 31 answered in whole or in part or has been answered in a manner that 32 does not fairly meet the question addressed. If the department 33 determines that an application is incomplete, the department shall 34 notify the applicant within 15 working days after the date the 35 application was received stating the reasons for its determination of 36 incompleteness, with reference to the particular questions for which 37 a deficiency is noted. 38 p. 4 HB 1072 (2) Within five working days of receipt of a completed 1 application, the department shall publish notice of the application 2 on the department's publicly accessible website and in a newspaper of 3 general circulation in the county or counties where the health care 4 entity is located and shall notify by first-class United States mail, 5 email, or fax any person who has requested notice of the filing of 6 such applications. The notice must state that an application has been 7 received, state the names of the intended parties, describe the 8 contents of the application, state the date and location of any 9 public hearings, and state the date by which a person may submit 10 written comments about the application to the department. 11 (3) Within five working days of receipt of a completed 12 application, the department must provide the completed application to 13 the attorney general. 14 NEW SECTION. Sec. 5. (1) Upon receipt of a completed 15 application under this chapter, the department must conduct a review 16 and issue a final determination within 60 days. If the department 17 fails to issue a final determination within 60 days, the health care 18 transaction is deemed approved. 19 (2)(a) The department may conduct up to two public hearings 20 during the course of review, at least one of which must be in the 21 health district most affected by the proposed health care 22 transaction. 23 (b) The department must allow individuals to participate remotely 24 in public hearings. 25 (c) At a public hearing, anyone may file written comments and 26 exhibits or appear and make a statement. 27 (d) A public hearing must be held not later than 30 days after 28 receipt of a completed application. All public hearings must be 29 completed not later than 45 days after receipt of a completed 30 application. At least 10 days' public notice must be given before the 31 holding of a public hearing. 32 (3) The department shall consult with the attorney general to 33 ensure that the applicants are also in compliance with chapter 19.390 34 RCW. 35 (4) The department shall consult with the health district or 36 districts affected by the proposed transaction to evaluate the 37 application and its foreseeable effects to protected health care 38 p. 5 HB 1072 services and community health care services under the standards 1 established in section 6 of this act. 2 PART III 3 TRANSACTION APPROVAL STANDARDS AND FINAL DETERMINATION 4 NEW SECTION. Sec. 6. (1) The department shall only approve or 5 approve with conditions or modifications an application under this 6 chapter if the department determines that: 7 (a) The health care transaction subject to review under this 8 chapter will not, at the time of transaction, foreseeably and 9 meaningfully reduce access to protected health care services in one 10 or more health districts; 11 (b) The health care entity engaging in the health care 12 transaction subject to review under this chapter has or plans to take 13 sufficient safeguards to address any reduction in access to protected 14 health care services such that the health care transaction will not 15 meaningfully reduce the continued existence of protected health 16 services within one or more health districts, or that sufficient 17 alternative sources of care are available in the health district; or 18 (c) The health care transaction is necessary to preserve access 19 to community health care services because, without the transaction, 20 the residents of one or more health districts are more likely than 21 not to lose community health care services that would meaningfully 22 reduce access to care for these residents, including hospital care, 23 emergency care, specialty care, primary care, obstetric services, or 24 other services important to the community. 25 (2) In determining whether to approve, approve with conditions or 26 modifications, or deny an application under this section, the 27 department shall consider the following information alongside the 28 application received from the parties of the health care transaction: 29 (a) Information and analysis provided in the report required 30 under section 11 of this act regarding existing access to protected 31 health care services in the health district or districts that would 32 be affected by the transaction, and the effect of the health care 33 transaction on existing access; 34 (b) If applicable, information provided in the most recent 35 community health needs assessment under Title 26 U.S.C. Sec. 501 36 relevant to protected health care services; 37 p. 6 HB 1072 (c) Comments, information, and statements provided at public 1 hearings pursuant to section 5 of this act; 2 (d) The share of residents within the health district or 3 districts who would have their current site of care for protected 4 health care services or community health care services relocated, and 5 whether such relocation would add barriers to accessing protected 6 health care services or community health care services to those 7 residents; and 8 (e) The share of residents within the health district or 9 districts who would have the modality of accessing protected health 10 care services or community health care services changed from only 11 brick-and-mortar to only virtual or on demand, and whether such 12 residents would have adequate access to necessary resources to access 13 virtual or on demand services. 14 NEW SECTION. Sec. 7. (1) The department shall make a final 15 determination regarding an application subject to review under this 16 chapter, with or without any specific modifications or conditions 17 based on the standards established in section 6 of this act. 18 (2)(a) Within 60 days of receipt of a completed application under 19 this chapter, the department shall make a final determination to: 20 (i) Approve the application in writing, which constitutes a final 21 decision; 22 (ii) Approve the application with conditions or modifications on 23 the transaction to ensure the requirements in section 6 of this act 24 are met. The imposition of such modifications or conditions must be 25 in writing and constitutes a final decision; or 26 (iii) Disapprove the application in writing, which constitutes a 27 final decision. 28 (b) The department shall make its final determination in writing 29 provided to all parties in the transaction, including findings and 30 justification of its determination related to the standards 31 established in section 6 of this act. 32 (c) The final determination must adhere to the notice 33 requirements in the same manner as under section 4(2) of this act. 34 (3)(a) The department may not make its decision subject to any 35 condition not directly related to the requirements of this chapter, 36 and any condition or modification, including the cost associated with 37 such condition or modification, must be reasonable and bear a direct 38 and rational relationship to the application under review. 39 p. 7 HB 1072 (b) Any modifications or conditions imposed by the department 1 must: 2 (i) Align with the relevant applicable standards of care for the 3 specific service or services affected by the modifications or 4 conditions; 5 (ii) Relate to the specific application and consider preservation 6 of access to health care services; and 7 (iii) Not impose undue financial burden to the parties such that 8 provision of health care services provided by the health care entity 9 cannot be done in a financially feasible manner. 10 (c) The decision to approve, approve with conditions or 11 modifications, or disapprove an application must take into account 12 whether disapproval of a plan, or specific conditions or 13 modifications, may lead to health care service disruption or loss of 14 community health care services to the community. 15 (4) A health care entity engaged in a health care transaction 16 subject to this chapter and affected by a final decision of the 17 department to approve, approve with conditions or modifications, or 18 disapprove an application has the right to an adjudicative proceeding 19 under chapter 34.05 RCW. 20 PART IV 21 ENFORCEMENT, RULE MAKING, AND CONTRACTING AUTHORITY 22 NEW SECTION. Sec. 8. The attorney general may seek an 23 injunction to prevent any health care transaction required to seek 24 and receive approval pursuant to section 3 of this act that is not 25 approved or approved with conditions or modifications by the 26 department under this chapter. 27 NEW SECTION. Sec. 9. (1) The department shall require annual 28 reports from the parties to a health care transaction that was 29 subject to review and approved or approved with conditions or 30 modifications under this chapter for the purpose of ensuring 31 compliance with the parties' application, the department's approval, 32 and this chapter. 33 (2) The department shall require annual reports under this 34 section for a period of not more than three years after the 35 completion of a transaction approved or approved with conditions or 36 modifications. 37 p. 8 HB 1072 NEW SECTION. Sec. 10. The department may adopt rules necessary 1 to implement this chapter and may contract with and provide 2 reasonable reimbursement to qualified persons to assist in 3 determining whether the requirements of section 6 of this act have 4 been met. 5 PART V 6 REPORT ON HEALTH CARE SERVICES 7 NEW SECTION. Sec. 11. (1) The department, in coordination with 8 the office of financial management under chapter 43.370 RCW and in 9 consultation with health districts, shall create a report on existing 10 access to protected health care services and community health care 11 services within individual health districts and statewide. 12 (2) The report must include a description of relevant population 13 demographics, the extent to which protected health care services and 14 community health care services are covered by state or federal 15 coverage programs or other health plans, and trends in relevant 16 health status and health care needs. 17 (3) The report must be made available publicly for the purposes 18 of health care planning and analysis. In doing so, the department 19 shall ensure that requirements for confidentiality of patient, 20 provider, and facility-specific records are met. 21 (4) The report must be made publicly available by December 1, 22 2026, and updated no less frequently than every two years. 23 PART VI 24 STATEWIDE HEALTH RESOURCES STRATEGY 25 Sec. 12. RCW 43.370.030 and 2010 1st sp.s. c 7 s 114 are each 26 amended to read as follows: 27 (1) The office shall develop a statewide health resources 28 strategy. The strategy shall establish statewide health planning 29 policies and goals related to the availability of health care 30 facilities and services, quality of care, and cost of care. The 31 strategy shall identify needs according to geographic regions 32 suitable for comprehensive health planning as designated by the 33 office. 34 (2) The development of the strategy shall consider the following 35 general goals and principles: 36 p. 9 HB 1072 (a) That excess capacity of health services and facilities place 1 considerable economic burden on the public who pay for the 2 construction and operation of these facilities as patients, health 3 insurance purchasers, carriers, and taxpayers; and 4 (b) That the development and ongoing maintenance of current and 5 accurate health care information and statistics related to cost and 6 quality of health care, as well as projections of need for health 7 facilities and services, are essential to effective strategic health 8 planning. 9 (3) The strategy, with public input by health service areas, 10 shall include: 11 (a) A health system assessment and objectives component that: 12 (i) Describes state and regional population demographics, health 13 status indicators, and trends in health status and health care needs; 14 and 15 (ii) Identifies key policy objectives for the state health system 16 related to access to care, health outcomes, quality, and cost- 17 effectiveness; 18 (b) A health care facilities and services plan that shall assess 19 the demand for health care facilities and services to inform state 20 health planning efforts ((and)), direct certificate of need 21 determinations((,)) for those facilities and services subject to 22 certificate of need as provided in chapter 70.38 RCW, and provide 23 information and analysis of protected health care services and 24 community health care services required under section 6 of this act. 25 The plan shall include: 26 (i) An inventory of each geographic region's existing health care 27 facilities and services, with specific analysis of the availability 28 of protected health care services and community health care services 29 as defined in section 2 of this act; 30 (ii) Projections of need for each category of health care 31 facility and service, including those subject to certificate of need; 32 (iii) Policies to guide the addition of new or expanded health 33 care facilities and services to promote the use of quality, evidence- 34 based, cost-effective health care delivery options, including any 35 recommendations for criteria, standards, and methods relevant to the 36 certificate of need review process; and 37 (iv) An assessment of the availability of health care providers, 38 public health resources, transportation infrastructure, and other 39 p. 10 HB 1072 considerations necessary to support the needed health care facilities 1 and services in each region; 2 (c) A health care data resource plan that identifies data 3 elements necessary to properly conduct planning activities and to 4 review certificate of need applications, including data related to 5 inpatient and outpatient utilization and outcomes information, and 6 financial and utilization information related to charity care, 7 quality, and cost. The plan shall inventory existing data resources, 8 both public and private, that store and disclose information relevant 9 to the health planning process, including information necessary to 10 conduct certificate of need activities pursuant to chapter 70.38 RCW. 11 The plan shall identify any deficiencies in the inventory of existing 12 data resources and the data necessary to conduct comprehensive health 13 planning activities. The plan may recommend that the office be 14 authorized to access existing data sources and conduct appropriate 15 analyses of such data or that other agencies expand their data 16 collection activities as statutory authority permits. The plan may 17 identify any computing infrastructure deficiencies that impede the 18 proper storage, transmission, and analysis of health planning data. 19 The plan shall provide recommendations for increasing the 20 availability of data related to health planning to provide greater 21 community involvement in the health planning process and consistency 22 in data used for certificate of need applications and determinations; 23 (d) An assessment of emerging trends in health care delivery and 24 technology as they relate to access to health care facilities and 25 services, quality of care, and costs of care. The assessment shall 26 recommend any changes to the scope of health care facilities and 27 services covered by the certificate of need program that may be 28 warranted by these emerging trends. In addition, the assessment may 29 recommend any changes to criteria used by the department to review 30 certificate of need applications, as necessary; 31 (e) A rural health resource plan to assess the availability of 32 health resources in rural areas of the state, assess the unmet needs 33 of these communities, and evaluate how federal and state 34 reimbursement policies can be modified, if necessary, to more 35 efficiently and effectively meet the health care needs of rural 36 communities. The plan shall consider the unique health care needs of 37 rural communities, the adequacy of the rural health workforce, and 38 transportation needs for accessing appropriate care. 39 p. 11 HB 1072 (4) The office shall submit the initial strategy to the governor 1 and the appropriate committees of the senate and house of 2 representatives by January 1, 2010. Every two years the office shall 3 submit an updated strategy. The health care facilities and services 4 plan as it pertains to a distinct geographic planning region may be 5 updated by individual categories on a rotating, biannual schedule. 6 (5) The office shall hold at least one public hearing and allow 7 opportunity to submit written comments prior to the issuance of the 8 initial strategy or an updated strategy. A public hearing shall be 9 held prior to issuing a draft of an updated health care facilities 10 and services plan, and another public hearing shall be held before 11 final adoption of an updated health care facilities and services 12 plan. Any hearing related to updating a health care facilities and 13 services plan for a specific planning region shall be held in that 14 region with sufficient notice to the public and an opportunity to 15 comment. 16 PART VII 17 MISCELLANEOUS PROVISIONS 18 NEW SECTION. Sec. 13. Sections 2 through 11 of this act 19 constitute a new chapter in Title 70 RCW. 20 NEW SECTION. Sec. 14. If any provision of this act or its 21 application to any person or circumstance is held invalid, the 22 remainder of the act or the application of the provision to other 23 persons or circumstances is not affected. 24 NEW SECTION. Sec. 15. This act takes effect December 1, 2026, 25 and applies to health care transactions with an effective date on or 26 after the effective date of this act, except for section 9 which 27 takes effect July 1, 2026. 28 --- END --- p. 12 HB 1072