All Roll Calls
Yes: 198 • No: 43
WashingtonHB 14322025-2026 Regular SessionHouseWALLET
Improving access to appropriate mental health and substance use disorder services.
Sponsored By: Tarra Simmons (Democratic)
Became Law
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Bill Overview
Analyzed Economic Effects
6 provisions identified: 4 benefits, 1 costs, 1 mixed.
Faster prior authorization and first visits
Starting January 1, 2027, prior authorization decisions get faster: electronic requests must be decided in 3 days (1 day expedited); paper in 5 days (2 days expedited). Insurers must post and share current prior-authorization rules and clinical criteria, and show provider tiers online when tiers change authorization rules. They must keep a written utilization review program and give criteria on request. For a new episode of outpatient mental health or substance use care, no prior authorization or other review applies to the first evaluation plus up to six treatment visits; these visits cannot be denied for medical necessity and still count toward any visit limits. Insurers must support electronic prior-authorization interfaces for health services by January 1, 2025, and for prescription drugs by January 1, 2027.
Mental health coverage at full parity
Beginning January 1, 2027, any plan that covers medical and surgical care also covers mental health and substance use care. Cost sharing and treatment limits must follow the federal parity rules at 89 Fed. Reg. 77586. If a plan covers a condition in one benefit category, it must offer meaningful treatment for it in every category where it covers medical or surgical care. Plans cannot deny or limit this care because they say a public program like Medicaid, Medicare, SSI, SSDI, or special education should pay. These rules bind insurers and health care benefit managers. Washington adopts the federal parity guidance, and the insurance commissioner can require data to check compliance. Older state mental health insurance statutes are repealed on January 1, 2027.
Stronger evidence-based reviews and appeals
Beginning January 1, 2027, insurers and reviewers must use generally accepted standards for mental health and substance use care. For level-of-care decisions, they must apply age‑appropriate placement criteria from nonprofit professional groups and authorize care that fits; denial letters must show the full assessment, and extra placement rules can only approve care, not deny it. Any consulting reviewer must hold a current license and be in the same or a related specialty. Drug review rules for behavioral health must be evidence‑based and kept up to date. Independent reviewers must follow these standards, use expert judgment, and can override unreasonable plan rules. After a denial, you can request the plan’s NQTL parity analyses, and the plan must provide them within 30 days at no cost.
Stronger protections for medical practices
Starting January 1, 2027, insurers cannot force providers to discount services that a plan does not cover. Insurer refund requests face deadlines: 6 months after payment for mental health or substance use claims (9 months if due to coordination of benefits). For other services, the limits are 24 months (30 months if coordination of benefits). If a provider contests a refund request, the insurer cannot demand payment sooner than 6 months after the provider receives the request. If a provider does not contest in writing within 30 days, the request is treated as accepted, with exceptions for fraud or third‑party responsibility.
Law depends on June 2025 funding
The act is canceled unless the legislature provides specific funding in the omnibus budget by June 30, 2025. Without that funding, the entire law becomes null and void.
Possible delay to electronic prior auth
To get a one‑year delay from the January 1, 2025 interface deadline for health services, an insurer must have filed a narrative with the insurance commissioner by September 1, 2024. The commissioner may grant a one‑year enforcement delay if the insurer shows a good‑faith effort. If federal API rules were not final by September 13, 2023, enforcement may instead be delayed until January 1, 2026.
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Sponsors & Cosponsors
Sponsor
Tarra Simmons
Democratic • House
Cosponsors
Alicia Rule
Democratic • House
Carolyn Eslick
Republican • House
Chris Stearns
Democratic • House
Gerry Pollet
Democratic • House
Joe Timmons
Democratic • House
Julia Reed
Democratic • House
Lauren Davis
Democratic • House
Nicole Macri
Democratic • House
Osman Salahuddin
Democratic • House
Roger Goodman
Democratic • House
Sharon Tomiko Santos
Democratic • House
Roll Call Votes
House vote • 4/22/2025
Final Passage as Amended by the Senate
Yes: 78 • No: 19 • Other: 1
Senate vote • 4/14/2025
3rd Reading & Final Passage as Amended by the Senate
Yes: 48 • No: 1
House vote • 3/11/2025
3rd Reading & Final Passage
Yes: 72 • No: 23 • Other: 3
Actions Timeline
Effective date 7/27/2025*.
5/12/2025HouseChapter 227, 2025 Laws.
5/12/2025HouseGovernor signed.
5/12/2025legislatureDelivered to Governor.
4/25/2025legislaturePresident signed.
4/24/2025legislatureSpeaker signed.
4/23/2025legislaturePassed final passage; yeas, 78; nays, 19; absent, 0; excused, 1.
4/22/2025HouseHouse concurred in Senate amendments.
4/22/2025HouseThird reading, passed; yeas, 48; nays, 1; absent, 0; excused, 0.
4/14/2025HouseRules suspended. Placed on Third Reading.
4/14/2025HouseCommittee amendment(s) adopted with no other amendments.
4/14/2025HousePlaced on second reading by Rules Committee.
4/9/2025HouseMinority; without recommendation.
4/8/2025HouseWM - Majority; do pass with amendment(s) by Health & Long-Term Care.
4/8/2025HousePassed to Rules Committee for second reading.
4/8/2025HouseReferred to Ways & Means.
3/29/2025HouseAnd refer to Ways & Means.
3/27/2025HouseMinority; do not pass.
3/27/2025HouseHLTC - Majority; do pass with amendment(s).
3/27/2025HouseFirst reading, referred to Health & Long-Term Care.
3/14/2025HouseThird reading, passed; yeas, 72; nays, 23; absent, 0; excused, 3.
3/11/2025HouseRules suspended. Placed on Third Reading.
3/11/2025HouseFloor amendment(s) adopted.
3/11/2025House2nd substitute bill substituted.
3/11/2025HouseRules Committee relieved of further consideration. Placed on second reading.
3/10/2025House
Bill Text
Session Law
5/15/2025
Bill as Passed Legislature
4/30/2025
Engrossed Second Substitute
3/12/2025
Second Substitute
3/3/2025
Substitute Bill
2/21/2025
Original Bill
1/21/2025
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