Oregon Health Bill Expands Psilocybin Access, Tightens Billing

HB 4040 would overhaul hospital charity care, provider licensing, and insurance coverage rules

Published on Feb. 15, 2026

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House Bill 4040, a sweeping health care reform package in Oregon, would expand access to psilocybin-assisted services, raise the threshold for hospital charity care screening, and implement new rules for insurers and providers. The bill aims to address gaps in the state's health system, though some critics argue it mixes needed consumer protections with controversial expansions.

Why it matters

The proposed changes in HB 4040 could significantly impact access to psilocybin therapy, financial assistance for low-income patients, and insurance coverage for certain medical devices and services in Oregon. The bill touches on a range of health care policies that will affect providers, insurers, and patients across the state.

The details

HB 4040 would allow out-of-state psilocybin training programs to qualify for Oregon licensure, expand the pool of potential psilocybin facilitators to include occupational and physical therapists, raise the charity care screening threshold from $500 to $1,500, require hospitals to notify patients of charity care decisions, and bar insurers from refusing to pay for anesthesia based on time limits. The bill also includes provisions related to workers' compensation, prosthetic device coverage, and payment for caregivers of minors with disabilities.

  • HB 4040 was advanced by the Oregon House Health Care Committee on a unanimous 8-0 vote in February 2026.
  • The bill would take effect immediately upon being signed into law by the governor.

The players

Oregon House Health Care Committee

The legislative committee that advanced HB 4040 and is overseeing the bill's progress.

Rep. Rob Nosse

The Oregon state representative who requested HB 4040 on behalf of the House Health Care Committee, describing it as an effort to cut red tape and shore up services amid a tight budget.

Adam Zarrin

A consumer advocate who expressed concerns that raising the charity care threshold in HB 4040 could actually make it harder for low-income patients to qualify for financial assistance.

Oregon Health Authority

The state agency that maintains a list of approved psilocybin training programs and is updating facilitator requirements as part of HB 4040.

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What they’re saying

“In practice, that means many low-income patients would no longer qualify for charity care unless they rack up significantly higher bills first.”

— Adam Zarrin, Consumer advocate (The Oregonian/OregonLive)

What’s next

The fate of HB 4040 will depend on whether lawmakers decide to address individual provisions separately or keep the omnibus bill intact as it moves through the legislative process.

The takeaway

HB 4040 represents a broad attempt to reform Oregon's health care system, touching on issues ranging from psilocybin access to hospital charity care and insurance coverage. While the bill aims to address gaps in the state's health policies, it has drawn both support and criticism, highlighting the complex and sometimes controversial nature of health care legislation.