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2022 WSMA Interim Priorities

2022 WSMA Interim Priorities

The WSMA’s advocacy efforts occur year-round, including during the interim period between legislative sessions. Interim advocacy takes a different form than our work during session, mostly focusing on submitting comments on regulatory proposals, attending and providing public testimony at implementation workshops, participating in work groups, building relationships with candidates running for office, and preparing for our work ahead in the upcoming legislative session.

The following is a look at the activities and issues your government affairs and policy team dedicate their time to during the interim.

2023 Agenda Outreach

Each year, WSMA’s government affairs team launches an interim advocacy survey as an opportunity for us to learn about current issues facing the physician community and to hear from WSMA members on issues they would like to see us take on in the upcoming session. Your feedback helps determine what legislation we engage on and how we orient to proposals that are brought forward.

WSMA members receive our annual advocacy survey to generate feedback on the issues that impact you and what you want us to focus our advocacy on. If there's a topic or issue facing the house of medicine that you would like us to consider in the upcoming session, reach out to WSMA Director of Government Affairs Sean Graham at


While legislative sessions are usually the busiest time of year for your government affairs team, during the interim is when state agency rulemaking season ramps up. Passed legislation may require rulemaking for implementation, which you can read about here. Your policy team monitors and engages on rules impacting the house of medicine.

Below are activities your policy team is working on this interim.

Rulemakings initiated by the 2022 legislative session and carryover rulemakings from previous sessions:

Office of the Insurance Commissioner

HB 1688: Balance billing
  • Seeks to align the state’s Balance Billing Protection Act with the Federal No Surprises Act.
HB 1821: Audio-only telemedicine
  • Redefines what constitutes an “established relationship” for the purposes of insurance coverage for audio-only telemedicine services.

Department of Health

SB 5765: Midwifery
  • Upon completion of additional study and training requirements established by the Department of Health in rule, allows midwives to be granted a limited prescriptive license extension to prescribe, obtain, and administer antibiotic, antiemetic, antiviral, antifungal, low-potency topical steroid, and antipruritic medications and therapies, and hormonal and nonhormonal family planning devices.
HB 1881: Doulas
  • Establishes the health care profession of “birth doula,” nonmedical birth coaches or support persons trained to provide support during labor, birth, and the postpartum period.
HB 1616: Charity care
  • Increases the pool of patients eligible for charity care and establishes rates at which discounts apply.
SB 5496: Washington health professional monitoring programs
  • Modernizes language pertaining to the Washington Physicians Health Program to ensure confidentiality for those who access the program for reasons outside of substance use disorder.
HB 1893: EMT collaborative care
  • Expands the scope of practice of emergency medical technicians to include providing “collaborative medical care” within the EMT’s training and certification.

Department of Social and Health Services

HB 1886: Apple Health and Homes program
  • Establishes the Apple Health and Homes program, which would provide supportive housing benefits in renewable 12-month periods for individuals enrolled in Medicaid and receiving community support services.

Health Care Authority

HB 5532: Prescription drug affordability board
  • Establishes a prescription drug affordability board at the Health Care Authority.


SB 5753: Revamp of boards and commissions
  • Revises state law pertaining to health care boards and commissions.

Other rulemakings:

Office of the Insurance Commissioner

HB 1477: Consolidated health care
  • Rulemaking was initiated to adopt reporting requirements regarding access to next-day services to ensure enrollees are receiving vital services for the prevention of suicide.
  • This rulemaking was made permanent on April 11, 2022 and takes effect on May 12, 2022.

Department of Health

SB 5229: Health equity CME
  • Rulemaking is required to consider creating model rules establishing minimum standards for health equity continuing education programs for health professions licensed under Title 18 RCW. The WSMA provided comment to the Department of Health requesting that the number of hours of health equity continuing education be determined by the secretary for secretary professions and that relevant boards and commissions decide the number of hours for non-secretary professions.
  • The WSMA has policy on health equity that has helped guide our advocacy efforts.
HB 1378: Medical assistants
  • The rulemaking process is addressing revisions to seven sections of medical assistant rules, including telemedicine supervision requirements. The WSMA provided feedback to the Department of Health clarifying that supervision requirements should be determined by the supervising physician’s or health care professional’s clinical judgment in consultation with the medical assistant and the patient’s medical history.
HB 1152: Nonelected members of local boards of health
  • Rulemaking is underway to establish the selection and appointment process for nonelected members of local boards of health.

Washington Medical Commission

SB 6551: International medical graduates
  • Current rulemaking includes the consideration of creating an exceptional qualification waiver for international medical graduates pursuing a full medical license, as well as the creation of a time-limited clinical experience license.

Labor & Industries

Ambient heat exposure
  • The rulemaking process is considering occupational health exposure hazards from high ambient temperatures in all industries, including outdoor and indoor exposures.

Board of Naturopathy

Nonsurgical cosmetic procedures
  • Rulemaking is set to expand naturopaths’ scope of practice to include nonsurgical cosmetic procedures, including botulinum toxin, dermal fillers, and other inert substances, without stipulating additional education requirements or training. The WSMA shared feedback with the Board of Naturopathy requesting that it rescind this proposal due to significant risk of patient harm and the absence of requisite education and training.

Other activities your policy team is working on this interim:

  • Submitting comment letters or providing testimony on rulemakings the WSMA is actively engaged with.
  • Working with resolution authors and staff on the preparation and organization of policy proposals for the 2022 Annual Meeting of the WSMA House of Delegates.
  • Participating in and providing feedback to the Health Care Cost Transparency Board.
  • Sharing comments on relevant sunrise reviews at the Department of Health, a process which examines a health profession’s scope of practice for possible expansion.
  • Creating guidance documents reflective of current or new policies and practices as resources for WSMA members.


Midterm elections will take place this interim and there are more than 100 seats up for grabs throughout Washington state. As a result, much of our work will revolve around interviewing and connecting with candidates running for the state Legislature. We’ll also spend a good amount of time developing our legislative agenda for the upcoming session.

The following activities are among those your government affairs team is participating in this interim:

  • Debriefing on the outcomes of the 2022 legislative session in WSMA’s post-session Advocacy Council webinar.
  • Building relationships with statewide candidates running for election or reelection in the midterm cycle whose priorities align with the house of medicine.
  • Raising awareness of WSMA’s nonpartisan political campaign arm, the Washington Medical Political Action Committee (WAMPAC).
  • Preparing WSMA’s 2023 legislative agenda. Reach out to Sean Graham at if you have a topic related to the house of medicine that you’d like to see included in our agenda!
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