[US] SB4754: Primary and Behavioral Health Care Access Act of 2026
Impact on your practice
This federal bill could fundamentally reshape how insurers reimburse behavioral health by requiring parity with primary care. If passed, it would likely improve reimbursement rates and reduce prior authorization barriers nationwide.
Key facts
Federal bill requiring integrated primary and behavioral health care access
Currently in Senate HELP Committee—early stage but bipartisan interest likely
Could mandate insurance coverage parity and reimbursement equity between primary and behavioral health
Addresses systemic barriers to mental health care access at federal level
Companion bill (HB9257) in House indicates serious legislative momentum
Original source
https://legiscan.com/US/bill/SB4754/2025Policy changes drive denial patterns
Therapy Companion tracks both: the policy shifts on this page and the denial patterns hitting your claims.
Related policy changes
New York failed to ensure Medicaid insurers followed mental health parity rules: OIG
This audit provides concrete evidence of parity violations in a major state Medicaid program and creates enforcement leverage for therapists and advocates. Expect increased scrutiny of prior authorization practices nationally and potential regulatory action requiring MCOs to align mental health and medical denial rates.
[WA] HB1432: Improving access to appropriate mental health and substance use disorder services.
WA's HB1432 is now law and will take effect mid-2025. Therapists should review the full text to understand new access requirements, which may affect prior authorization processes, network participation, or documentation standards.
[OK] HB2049: Medicaid parity; coverage; mental health and substance use disorders; contract compliance; noncompliance reviews; Oklahoma Health Care Authority; complaints; publication of reports; effective date.
Oklahoma therapists treating Medicaid patients now have explicit parity enforcement mechanisms and public accountability for MCO compliance. This should reduce discriminatory prior authorization practices and coverage denials for behavioral health in Medicaid.
[MD] HB280: Health Insurance - Mental Health and Substance Use Disorders - Codification of Federal Requirements
Maryland therapists gain stronger state-level parity protections by embedding federal requirements into state insurance code. This creates dual enforcement pathways (state and federal) and may improve prior authorization consistency and coverage denials for mental health services.