S-0256.1
SENATE BILL 5373
State of Washington 68th Legislature 2023 Regular Session
By Senators Randall, Holy, Dhingra, Hunt, Cleveland, C. Wilson,
Saldaña, Van De Wege, Conway, Frame, Hasegawa, Keiser, Kuderer,
Liias, Lovelett, Nguyen, Nobles, Robinson, and Valdez
Read first time 01/13/23. Referred to Committee on Health & Long
Term Care.
1 AN ACT Relating to requiring health carriers to reimburse
2 advanced registered nurse practitioners and physician assistants at
3 the same rate as physicians for the same services; reenacting and
4 amending RCW 41.05.017; adding a new section to chapter 48.43 RCW;
5 and creating a new section.
6 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
7 NEW SECTION. Sec. 1. Health care workforce shortages are one of
8 the most significant, and potentially long-lasting, impacts of the
9 COVID-19 pandemic. Given the gravity of these shortages and the
10 threat they present to health care access, the legislature recognizes
11 the importance of supporting health care practitioners throughout the
12 state. This act intends to help health systems, clinics, and private
13 practices maintain a sufficient number of health care providers,
14 especially in underserved and rural communities, by requiring health
15 carriers to reimburse advanced registered nurse practitioners,
16 physician assistants, and physicians the same rate for providing the
17 same health care services.
18 NEW SECTION. Sec. 2. A new section is added to chapter 48.43
19 RCW to read as follows:
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 1 (1) For health plans issued or renewed on or after January 1,
2 2024, a health carrier may not reimburse a contracted health care
3 practitioner who is an advanced registered nurse practitioner
4 licensed under chapter 18.79 RCW or physician assistant licensed
5 under chapter 18.71A RCW in an amount less than the allowed amount
6 that the health carrier would reimburse for the same service if
7 provided by a contracted provider who is a physician licensed under
8 chapter 18.57 or 18.71 RCW in the same service area as defined in WAC
9 284-43-0160.
10 (2) A health carrier may not reduce the reimbursement amount paid
11 to physicians licensed under chapter 18.57 or 18.71 RCW to comply
12 with this section.
13 (3) The office of the insurance commissioner shall collect data
14 from insurers on the implementation of this act beginning January 1,
15 2024, and report back to the legislature, in the manner provided in
16 RCW 43.01.036, no later than January 1, 2025:
17 (a) The number of insurers who changed reimbursement rates in
18 response to this act;
19 (b) The number of advanced registered nurse practitioners and
20 physician assistants whose reimbursement rates were increased as a
21 result of this act;
22 (c) The number of physicians whose reimbursement rates were
23 decreased as a result of this act; and
24 (d) The costs incurred by each insurer to implement this section.
25 (4) This section does not apply to advanced registered nurse
26 practitioners or physician assistants who are employees of a health
27 maintenance organization regulated under chapter 48.46 RCW.
28 Sec. 3. RCW 41.05.017 and 2022 c 236 s 3, 2022 c 228 s 2, and
29 2022 c 10 s 2 are each reenacted and amended to read as follows:
30 Each health plan that provides medical insurance offered under
31 this chapter, including plans created by insuring entities, plans not
32 subject to the provisions of Title 48 RCW, and plans created under
33 RCW 41.05.140, are subject to the provisions of RCW 48.43.500,
34 70.02.045, 48.43.505 through 48.43.535, 48.43.537, 48.43.545,
35 48.43.550, 70.02.110, 70.02.900, 48.43.190, 48.43.083, 48.43.0128,
36 48.43.780, 48.43.435, 48.43.815, ((and)) chapter 48.49 RCW, and
37 section 2 of this act.
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