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OregonHB 20132025 Regular SessionHouseWALLET

Relating to mental health treatment providers.

Sponsored By: Rob Nosse (Democratic)

Became Law

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Bill Overview

Analyzed Economic Effects

5 provisions identified: 3 benefits, 1 costs, 1 mixed.

Better access and out-of-network protection

Insurers must keep behavioral health networks that meet state access standards. If no in‑network provider can deliver timely, medically necessary care in your area, your plan covers out‑of‑network care at in‑network cost sharing when the provider accepts in‑network rates. If a plan pays out‑of‑network for medical or surgical care, it must pay behavioral health out‑of‑network on the same terms and rates. Insurers must also set and update behavioral health provider rates using the same method they use for medical and surgical providers.

Equal mental health coverage and costs

The law requires your plan to cover mental health diagnosis and medically necessary treatment the same as other medical care. Your plan cannot charge higher copays, deductibles, or coinsurance for mental health than for similar medical care. It also cannot set stricter treatment limits or shorter durations for mental health care than for other care.

Stronger rights to needed mental health care

Coverage includes a behavioral health assessment and the services your care plan shows are medically needed, including crisis transition care. Insurers must use current accepted clinical standards and the latest level‑of‑care criteria, approve the level your score shows, and authorize the next higher level if the indicated one is unavailable. Outpatient coverage includes in‑home follow‑up when clinically indicated, and any homebound limits must also match those clinical rules. Utilization reviews must be led by licensed clinicians and follow NCQA or Medicare review standards; urgent admissions can be paid then reviewed, and advance inquiries get timely answers. Insurers must give providers and insured people the review criteria and free training materials.

Services plans do not have to cover

Plans do not have to cover school or halfway‑house education or sheltered living, psychoanalysis in training programs, court‑ordered sex‑offender treatment, or support groups. Long‑term residential mental health care over 45 days is not covered unless clinically needed. Covered outpatient care may still be provided while someone is temporarily in sheltered living when appropriate.

New certification and rules for providers

The Oregon Health Authority (OHA) certifies organizations that run distinct mental health programs not otherwise licensed or under OHA contract. OHA may charge application or certification fees, and those fees fund the certification work. Insurers cannot force specific billing codes or cut pay by code except for medical‑necessity reasons. Providers are eligible for reimbursement if they are OHA‑approved or certified, accredited by the Joint Commission or CARF for the level of care, part of an overnight structured program (at least 8 hours per day, 5 days per week), or delivering a covered benefit. Insurers and providers may use value‑based payments like capitation or bundled payments, and these do not have to match fee‑for‑service rates.

Sponsors & Cosponsors

Sponsor

  • Rob Nosse

    Democratic • House

Cosponsors

  • Lesly Muñoz

    Democratic • House

  • Travis Nelson

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 118 • No: 37

Senate vote • 5/21/2025

Third reading. Carried by Reynolds. Passed.

Yes: 26 • No: 0

Senate vote • 5/8/2025

Early Childhood and Behavioral Health: Heard and Reported Out

Yes: 4 • No: 0

House vote • 4/21/2025

Motion to substitute Minority Report for Committee Report failed.

Yes: 25 • No: 34

House vote • 4/21/2025

Third reading. Carried by Nosse. Passed.

Yes: 57 • No: 0

House vote • 4/8/2025

HBHHC: Heard and Reported Out with Amendments

Yes: 6 • No: 3

Actions Timeline

  1. Chapter 190, (2025 Laws): Effective date January 1, 2026.

    6/11/2025House

  2. Governor signed.

    5/28/2025House

  3. President signed.

    5/22/2025Senate

  4. Speaker signed.

    5/22/2025House

  5. Third reading. Carried by Reynolds. Passed.

    5/21/2025Senate

  6. Carried over to 05-21 by unanimous consent.

    5/20/2025Senate

  7. Carried over to 05-20 by unanimous consent.

    5/19/2025Senate

  8. Second reading.

    5/15/2025Senate

  9. Recommendation: Do pass the A-Eng. bill.

    5/15/2025Senate

  10. Work Session held.

    5/8/2025Senate

  11. Public Hearing held.

    5/6/2025Senate

  12. Referred to Early Childhood and Behavioral Health.

    4/22/2025Senate

  13. First reading. Referred to President's desk.

    4/22/2025Senate

  14. Third reading. Carried by Nosse. Passed.

    4/21/2025House

  15. Motion to substitute Minority Report for Committee Report failed.

    4/21/2025House

  16. Second reading.

    4/17/2025House

  17. Minority Recommendation: Do pass with different amendments and be printed A-Engrossed.

    4/15/2025House

  18. Recommendation: Do pass with amendments and be printed A-Engrossed.

    4/15/2025House

  19. Work Session held.

    4/8/2025House

  20. Public Hearing held.

    2/11/2025House

  21. Referred to Behavioral Health and Health Care.

    1/17/2025House

  22. First reading. Referred to Speaker's desk.

    1/13/2025House

Bill Text

  • Enrolled

    5/21/2025

    PDF

  • A-Engrossed

    4/15/2025

    PDF

  • House Amendments to Introduced

    4/15/2025

    PDF

  • House Minority Amendments to Introduced

    4/15/2025

    PDF

  • Minority Report A-Engrossed

    4/15/2025

    PDF

  • HBHHC Amendment -1 (Adopted)

    4/8/2025

    PDF

  • HBHHC Amendment -2 (Proposed)

    4/8/2025

    PDF

  • HBHHC Amendment -MR3 (Proposed)

    4/8/2025

    PDF

  • HBHHC Amendment -1 (Proposed)

    4/3/2025

    PDF

  • Introduced

    1/10/2025

    PDF

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