wa-law.org > bill > 2025-26 > HB 1430 > Substitute Bill
Health care workforce shortages are one of the most significant, and potentially long-lasting, impacts of the COVID-19 pandemic. Given the gravity of these shortages and the threat they present to health care access, the legislature recognizes the importance of supporting health care practitioners throughout the state. This act intends to help health systems, clinics, and private practices maintain a sufficient number of health care providers, especially in underserved and rural communities, by requiring health carriers to reimburse advanced practice registered nurses, physician assistants, and physicians the same rate for providing the same health care services.
For health plans other than health plans offered to public employees and dependents under chapter 41.05 RCW issued or renewed on or after January 1, 2026, a health carrier may not reimburse a contracted health care practitioner who is an advanced practice registered nurse licensed under chapter 18.79 RCW or physician assistant licensed under chapter 18.71A RCW in an amount less than the amount that the health carrier would reimburse for the same service if provided by a contracted provider who is a physician licensed under chapter 18.57 or 18.71 RCW in the same service area. A carrier may not pay a contracted physician licensed under chapter 18.57 or 18.71 RCW more by making nonclaims based payments to physicians that are not also made available to advanced practice registered nurses licensed under chapter 18.79 RCW or physician assistants licensed under chapter 18.71A RCW for the same service in the same service area.
A health carrier may not reduce the reimbursement amount paid to physicians licensed under chapter 18.57 or 18.71 RCW to comply with this section.
The office of the insurance commissioner shall collect data on the implementation of this section beginning January 1, 2026, from health carriers or from other available sources, including but not limited to the all-payer health care claims database established in RCW 43.371.020. The commissioner shall report to the relevant committees of the legislature, in the manner provided in RCW 43.01.036, no later than July 1, 2027:
The number of health carriers that changed reimbursement rates in response to this section;
The number of advanced practice registered nurses and physician assistants whose reimbursement rates were increased as a result of this section;
The number of physicians whose reimbursement rates were decreased as a result of this section; and
The costs incurred by each health carrier to implement this section.
This section does not apply to advanced practice registered nurses or physician assistants who are employees of a health maintenance organization regulated under chapter 48.46 RCW.
For purposes of this section, "service area" means the geographic area or areas where a specific product is issued and rated, accepts members or enrollees, and covers provided services. A service area must be defined by the county or counties included unless, the commissioner permits limitation of a service area by zip code in rule or an applicable payment methodology uses an alternative service area designation.