WA · last verified 2026-05-12
Washington — NSA dispute pathway
Ground-ambulance balance-billing law
STATE LAW APPLIES
RCW 48.49 (BBPA), expanded by SSB 5986 (2024 c 218)
State IDR pathway
[VERIFY PENDING]
Federal IDR (45 CFR §149.510)
ERISA self-funded plans
STATE DOI HAS NO JURISDICTION
Self-funded plans always route to Federal IDR + DOL/EBSA enforcement, regardless of state.
How Washington fits the NSA picture
Washington SSB 5986 (2024 c 218) added ground-ambulance services to the Balance Billing Protection Act (Chapter 48.49 RCW). Nonparticipating GASOs may not balance-bill enrollees for covered services on plans issued/renewed on or after 2025-01-01.
State DOI consumer-protection entry ↗Statute: RCW 48.49 (BBPA), expanded by SSB 5986 (2024 c 218)
Free first step — CMS No Surprises Help Desk
The CMS-administered consumer complaint pathway. Free, federal, and the recommended first action for any balance-billed insured patient. You have 90 calendar days from when you knew or should have known of the NSA violation to file.