November 5, 2025

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Public comment now open for WA’s Traditional Health Care Practices waiver

The Health Care Authority (HCA) invites you to share your thoughts on Washington state's draft application for a Traditional Health Care Practices waiver. This is a five-year Section 1115 waiver available through the Centers for Medicare & Medicaid Services (CMS). It focuses on spiritual, cultural, and traditional healing in Native communities.

The public comment period begins today, Wednesday, November 5 and ends Friday, December 5, 2025.

About the waiver

If approved, this waiver will allow certain types of facilities in the state to provide traditional health care services as “qualifying facilities,” including:

• Indian Health Service (IHS) facilities
• Tribal facilities
• Urban Indian Health Organizations (UIHOs), depending on state funding from the Legislature

When a qualifying facility provides traditional health care services to an eligible Apple Health (Medicaid) or Children’s Health Insurance Program (CHIP) enrollee, Medicaid will reimburse (pay) that facility for the service.

How to provide input

1. Attend a public hearing (see dates and times below)
2. Email us
3. Mail us or drop off at:
   Health Care Authority, Office of Tribal Affairs
   Regarding: Traditional Health Care Practices waiver public comment
   Attention: Lena Nachand
   P.O. Box 45502
   Olympia, WA 98504-5502

The deadline to provide public comment is Friday, December 5 at 5 p.m. (Pacific). We strongly encourage early submissions.

Who can share input

Public comment is open to anyone who would like to share input, especially Tribal Nations, Indian health care providers, UIHOs, Tribal health organizations, and Native-serving organizations. We also encourage health care and social service providers, hospitals and health systems, community-based organizations, and anyone else interested in sharing their input.

Input we receive will help us learn more about people’s thoughts on reimbursing traditional health care services. It will also help inform our state’s waiver application.

Attend a public hearing

In partnership with Lummi Nation and Yakama Nation, HCA will hold two public hearings. During the hearings, attendees can ask questions, provide input, and attend in person, join virtually, or call in.

More information

• Visit our Traditional Health Care Practices waiver page
• Sign up to receive our emails
• Read the:
  • Draft application
  • Executive summary
• Learn about the additional opportunities for Tribes to share input
• See some of the traditional health care practices a qualifying facility may use