This bill adds a new section to chapter 48.43 RCW creating a statutory reimbursement parity requirement: health carriers must reimburse contracted advanced practice registered nurses (APRNs, licensed under chapter 18.79 RCW) and physician assistants (PAs, licensed under chapter 18.71A RCW) at no less than the amount the carrier would reimburse for the same service when provided by a contracted physician (licensed under chapter 18.57 or 18.71 RCW) in the same service area, when the APRN or PA is providing primary care or behavioral health services (including medication management and therapy). The bill also prohibits carriers from making nonclaims-based payments to contracted physicians for a service that are not also made available to APRNs or PAs for the same service in the same service area, and it prohibits carriers from reducing physician reimbursement amounts to comply with the requirement. The change is a new statutory payment parity requirement combined with a procedural reporting mandate. It applies to health plans issued or renewed on or after January 1, 2026, excluding public-employee plans under chapter 41.05 RCW, and exempts APRNs and PAs who are employees of health maintenance organizations regulated under chapter 48.46 RCW. The Office of the Insurance Commissioner must begin collecting implementation data on January 1, 2026, and report specified implementation metrics to relevant legislative committees by July 1, 2027; the bill references the all-payer health care claims database as a potential data source. The bill creates a new law and a procedural data-collection requirement but does not describe enforcement mechanisms, penalties, or dispute resolution for noncompliance. The text provided does not define "health carrier" or "nonclaims-based payments," does not specify how to determine the "same service" (for example by code or other method), does not name the legislative committees to receive the report, and does not address self-funded or ERISA-governed plans.

If enacted, insurers selling most individual and group health plans in Washington will have to pay contracted nurse practitioners and physician assistants at least as much as they pay contracted physicians for primary care and behavioral health services, and they cannot shift extra compensation to physicians through off-claim payments that they do not also offer to APRNs and PAs. That will likely raise pay for many APRNs and PAs who previously received lower rates, create additional administrative and financial costs for carriers as they change rate schedules and payment practices, and limit insurers’ ability to use alternative nonclaims payments to favor physicians. Physicians should not see their claim-based rates cut to cover these changes, and APRNs and PAs employed by a health maintenance organization are excluded, as are public-employee plans under chapter 41.05 RCW. The Office of the Insurance Commissioner must start collecting implementation data on January 1, 2026 and report to the legislature by July 1, 2027, forcing carriers to track and disclose who’s had rate changes and what implementation cost them. Key practical uncertainties remain about which plans count as “health carriers,” what counts as the “same service,” how nonclaims payments are defined, how enforcement would work, and whether self-funded or ERISA-governed plans are affected, so insurers and providers may still face unclear compliance decisions until those details are resolved.