AN ACT Relating to delaying the use of the ASAM 4 criteria, treatment criteria for addictive, substance related, and co-occurring conditions;
Summary
SB 5361 delays the mandatory use of the updated ASAM Criteria, specifically the ASAM 4 treatment criteria for addictive, substance-related, and co-occurring conditions, including adolescent and transition-age youth versions. Under the bill, the Washington Health Care Authority and the Office of the Insurance Commissioner must jointly decide whether to adopt an updated ASAM version and, if so, determine the date by which Medicaid managed care organizations, carriers, and other relevant entities must begin using it. The agencies must also post their decision publicly on their websites.
The bill amends state law governing behavioral health treatment criteria by changing when updated ASAM standards take effect for Medicaid and insurance-related coverage and utilization decisions. It preserves agency discretion to delay adoption of the new criteria, and it sets a default deadline for use of the updated ASAM 4 criteria no later than January 1, 2026, unless the agencies jointly decide it should not be used. In practical terms, the bill affects how substance use disorder and co-occurring mental health conditions are assessed for treatment authorization and coverage across state-regulated systems.
Impact
The bill changes RCW provisions that incorporate ASAM treatment criteria into Washington’s behavioral health and insurance framework. It gives the Health Care Authority and the Office of the Insurance Commissioner joint authority to determine whether and when updated ASAM criteria must be used, affecting Medicaid managed care organizations, health carriers, and other entities that rely on those criteria for treatment placement and coverage decisions. The measure does not create a new treatment standard so much as it delays and conditions the transition to a newer one.
Sentiment
The bill appears to have broad bipartisan support and moved through both chambers with strong or unanimous committee approval and large floor majorities. The Senate passed it 47-2 and the House passed it 96-0, indicating general agreement that the state should control the timing of implementation of the updated ASAM criteria. The absence of recorded committee testimony in the provided materials suggests limited visible public controversy in the legislative record available here.
Contention
The main point of potential contention is timing: whether Washington should require immediate use of ASAM 4 or allow state agencies to delay adoption until they determine it is appropriate. Supporters likely favored flexibility for implementation, while any opposition would center on concerns that delaying updated criteria could slow access to newer assessment standards for people with substance use disorder or co-occurring conditions. The final votes show little organized resistance, with only two no votes in the Senate and none in the House.
Crossfiled
AN ACT Relating to delaying the use of the ASAM 4 criteria, treatment criteria for addictive, substance related, and co-occurring conditions;
AN ACT Relating to updating the definition of fetal death to ensure the calculation of gestational age is based on objective and clinically accurate criteria;