House Behavioral Health and Health Care Committee advances broad package of pharmacy, workforce and residential treatment bills; several sent to Ways and Means

The Oregon House Committee on Behavioral Health and Health Care on April 2025 advanced a wide-ranging set of bills addressing pharmacy benefit management, prior authorization, behavioral health workforce and residential treatment capacity, sending many to the Joint Committee on Ways and Means and moving others to the Rules Committee for further negotiation.

Committee Chair Nuss opened the session by saying the panel planned to move several bills to Rules and to work through a large number of measures. Several pharmacy-related bills — House Bills 3,134, 3,212 and 2,149 — were placed on the Rules calendar to allow insurers, providers and other stakeholders more time to resolve drafting issues.

Courtney Dresser of the Oregon Medical Association told the committee about House Bill 3,134, the bill that would align state law with federal CMS electronic prior authorization standards, and described ongoing negotiations with carriers. "We are very close to getting there. We just need a little more time, and that's why we're asking to go to rules," Dresser said. Mary Ann Cooper of Regence Blue Cross Blue Shield of Oregon told lawmakers the challenge is accurately importing CMS rules without creating unintended carve-outs or overbroad cross-references: "The biggest challenge for us is making sure that the import of the federal rules is correct," she said.

On pharmacy benefit managers and related regulation, Chair Nuss said the committee had taken up the matter repeatedly over the last decade and planned to give parties more time to negotiate. Vice Chair Gevany moved House Bill 3,212 "without recommendation" and the committee sent it to Rules by unanimous consent.

Several measures tied to behavioral health capacity, workforce and payment policy were sent to Ways and Means for further analysis or with fiscal notes attached. Key appropriations and program bills include:

- House Bill 20 24 (dash 3): a grant program to support recruitment and retention of behavioral health workers and an incentive payment program, with an appropriation of $45,000,000 from the General Fund for 2025–27. The committee adopted the dash 3 amendment and referred the bill to Ways and Means.

- House Bill 2,059 (dash 2): establishes a residential behavioral health capacity program within the Oregon Health Authority (OHA), directs OHA to develop guidelines for distributing funds regionally, and appropriates $90,000,000 from the General Fund for the 2025–27 biennium. The amendment was adopted and the bill was referred to Ways and Means.

- House Bill 20 15 (dash 3): directs OHA to study flexibilities for administering residential treatment services benefits and to assess nurse staffing and reimbursement methodologies; the dash 3 was adopted and the bill was referred to Ways and Means.

Several implementation- and study-focused measures were also advanced: House Bill 2,206 (work group to study transferring responsibility for adult mental health residential benefit to CCOs) and House Bill 2,203 (behavioral health worker safety requirements and noncompetitive grants administered by OHA) were both adopted as amended and sent to Ways and Means. Chair Nuss emphasized the need to increase both facility capacity and workforce: "We obviously need workers to work in those places, but we also need more places where humans who need a higher level of care than outpatient can go," the chair said.

Measures affecting providers and licensure advanced as well. The committee adopted the dash 1 amendment to House Bill 20 16 (licensure-record removal for certain disciplinary information) and passed the bill to the floor with a due-pass recommendation. House Bill 20 13, which would add licensed outpatient facilities employing certified alcohol and drug counselors as providers for commercial insurance mental-health coverage, passed the committee as amended and will go to the House floor; the committee rejected a dash 2 amendment (an Interstate Licensure Compact for social workers) but adopted the dash 1 amendment clarifying facility program certification requirements.

The committee acted on several bills tied to audit and billing practices for behavioral health providers. House Bill 20 29 (claim-audit standards and an OHA education unit) was amended to clarify definitions and an operative date of Jan. 1, 2027; the dash 1 was adopted and the bill was sent to Ways and Means. House Bill 3,243 (limits and reporting for ground ambulance balance billing and a requirement that ambulance providers report rates) was amended (dash 3), adopted, and referred to Ways and Means.

On the subject of recovery residences, House Bill 2,239 as amended (dash 5) removed a requirement that OHA adopt minimum quality and performance standards and retained other contracting and certification provisions; stakeholding groups including Oxford House signaled support for the dash 5 amendment, and the bill went to Ways and Means.

Commitments for future work and fiscal caution featured repeatedly. Multiple members and staff noted that Legislative Fiscal Office (LFO) had issued "fiscal light" statements and requested further analysis for several bills, and Chair Nuss repeatedly said the committee was sending measures to Ways and Means or Rules to give LFO time and to encourage stakeholders to keep negotiating.

Votes at a glance

The committee handled many items by consent or roll call. Major procedural outcomes included:

- House Bill 3,134 (electronic prior authorization alignment) — moved to Rules without recommendation (consensus/acclamation).

- House Bill 3,212 (PBM regulation) — moved to Rules without recommendation (unanimous consent).

- House Bill 2,149 (pharmacy services organizations) — moved to Rules without recommendation.

- House Bill 20 13 (licensed outpatient facilities as covered providers) — dash 2 (Interstate Social Worker Compact) failed on roll call; dash 1 adopted; bill passed out of committee with due-pass to the floor (roll-call votes recorded for amendments and final motion).

- House Bill 20 15 (study of residential treatment administration and alternative staffing/reimbursement) — dash 3 adopted; bill referred to Ways and Means.

- House Bill 20 16 (board discipline record removal) — dash 1 adopted; bill sent to the floor with due-pass recommendation.

- House Bill 20 24 (workforce recruitment and retention grant program; $45,000,000 GF) — dash 3 adopted; referred to Ways and Means.

- House Bill 20 29 (claim audits for behavioral health providers) — dash 1 adopted; referred to Ways and Means.

- House Bill 2,059 (residential behavioral health capacity program; $90,000,000 GF) — dash 2 adopted; referred to Ways and Means.

- House Bill 2,203 (Behavioral Health Worker Safety Task Force provisions and employer duties) — dash 3 adopted; referred to Ways and Means.

- House Bill 2,202 (placeholder/study; Interstate Licensure Compact for counselors) — dash 2 (compact) failed; dash 1 adopted; bill referred to Ways and Means.

- House Bill 2,239 (recovery residences) — dash 5 adopted; bill referred to Ways and Means.

- House Bill 2,326 (seniors emergency dental program) — dash 2 adopted; referred to Ways and Means.

- House Bill 2,597 (increase DCO reimbursement floor and review) — motion adopted; referred to Ways and Means for analysis.

- House Bill 2,940 (sickle cell/hemoglobinopathies) — dash 1 replaced task force with OHA program and the committee rescinded subsequent referral to Ways and Means; bill advanced to the floor.

- House Bill 3,214 (medical marijuana: Ryan's Law; hospice/residential permissions) — dash 4 adopted; bill referred to Ways and Means.

- House Bill 3,243 (ambulance balance-billing provisions and public rate reporting) — dash 3 adopted; referred to Ways and Means.

- House Bill 3,245 (methodology study for CCO global budget accounting for CCO investments) — dash 2 adopted; referred to Ways and Means.

- House Bill 3,326 (senior emergency dental pilot) — dash 2 adopted; referred to Ways and Means.

- House Bill 3,380 (rural volunteer EMS tax credit) — referred to Revenue by prior reference.

- House Bill 3,817 (ibogaine study) — dash 1 adopted; referred to Ways and Means.

- House Bill 3,824 (physical therapy practice changes) — dash 1 adopted; passed to the floor.

- House Bill 3,902 (nursing faculty advisory committees) — dash 4 adopted; referred to Ways and Means.

- House Bill 3,916 (public-health workforce appropriation changes) — dash 1 adopted; referred to Ways and Means.

- House Bill 3,942 (expedited reissuance of health-care facility license for recently closed facilities) — dash 1 adopted; sent to the floor.

Why it matters

Committee members and witnesses framed these items as incremental but necessary steps to expand capacity (facilities and workforce), reduce administrative friction for patients and clinicians, and tighten consumer protections around audits and surprise billing. Several bills carry significant proposed General Fund appropriations or trigger LFO requests for further fiscal analysis; those measures will be shaped further in Ways and Means.

What to watch next

Stakeholder negotiations on the pharmacy bills in Rules; LFO analyses and Ways and Means hearings on the $45 million and $90 million workforce/capacity appropriations and on measures with fiscal-light tags; further drafting on ambulance balance billing and any proposed caps; and the status reports committee chairs requested from parties working on electronic prior authorization alignment with CMS rules.

Ending

Chair Nuss closed the lengthy session by thanking members and staff and said the committee would continue to consider Senate bills and other measures in April and May. "We give as many bills as possible a chance," the chair said, noting the committee's goal of moving a broad package while preserving opportunities for further fiscal and policy review.