December 1, 2025

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Public comment period extended for WA’s Traditional Health Care Practices waiver

On November 5, the Health Care Authority (HCA) sent an initial announcement about the open public comment period for Washington state's Traditional Health Care Practices draft application waiver. This is a five-year Section 1115 waiver available through the Centers for Medicare & Medicaid Services (CMS).

We are extending the public comment period and offering two more public hearings.

This extension does not change our waiver application submittal date (December 31) or the previously scheduled Tribal listening session or Tribal Consultation.

The public comment period began Wednesday, November 5 and now ends Friday, December 20, 2025.

More public hearings

About the waiver

If approved, the Traditional Health Care Practices 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 above)
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 new deadline to provide public comment is Saturday, December 20 at 5 p.m. (Pacific). 

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.

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