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(iii) Continue to maintain a medicaid population at similar 1 utilization levels as in calendar year 2022; 2 (iv) Be necessary for an adequate provider network for the 3 medicaid program; 4 (v) Demonstrate a plan for long-term financial sustainability; 5 and 6 (vi) Meet one of the following criteria: 7 (A) Lack adequate cash-on-hand to remain financially solvent; 8 (B) Have experienced financial losses during hospital fiscal year 9 2022; or 10 (C) Be at risk of bankruptcy. 11 (c) Of the amounts appropriated in this subsection, $4,000,000 12 must be distributed to a hospital that meets the qualifications in 13 subsection (b) and is located on tribal land. 14 (62)(a) Sufficient funds are provided in this section for an 15 outpatient directed payment program. 16 (b) The authority shall: 17 (i) Maintain the program to support the state's access and other 18 quality of care goals and to not increase general fund—state 19 expenditures; 20 (ii) Seek approval from the centers for medicare and medicaid 21 services to expand the medicaid outpatient directed payment program 22 for hospital outpatient services provided to medicaid program managed 23 care recipients by UW Medicine hospitals and, at their option, UW 24 Medicine affiliated hospitals; 25 (iii) Direct managed care organizations to make payments to 26 eligible providers at levels required to ensure enrollees have timely 27 access to critical high-quality care as allowed under 42 C.F.R. 28 438.6(c); and 29 (iv) Increase medicaid payments for hospital outpatient services 30 provided by UW Medicine hospitals and, at their option, UW Medicine 31 affiliated hospitals to the average payment received from commercial 32 payers. 33 (c) Any incremental costs incurred by the authority in the 34 development, implementation, and maintenance of this program shall be 35 the responsibility of the participating hospitals. 36 (d) Participating hospitals shall retain the full amount of 37 payments provided under this program. 38 p. 234 ESSB 5187.SL