Bill > HB1432

This bill aims to improve access to mental health and substance use disorder services by updating Washington's mental health parity law and ensuring coverage of medically necessary care. The bill introduces several key provisions, including defining "medically necessary" services as those that address a patient's specific needs in accordance with generally accepted standards of care, and are clinically appropriate in type, frequency, extent, site, and duration. It expands the definition of mental health and substance use disorder services over time, with plans issued or renewed on or after January 1, 2027, required to cover a broader range of services based on diagnostic categories in the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases. The bill also establishes stricter guidelines for health carriers' clinical review criteria, requires faster prior authorization processes, limits the time frame for requesting refunds from healthcare providers, and mandates more transparent and accessible information about prior authorization requirements. Additionally, the bill aims to reduce administrative barriers for mental health and substance use disorder providers by simplifying network participation rules and ensuring more consistent medical necessity determinations. The legislation will take effect on January 1, 2027, and repeals several existing statutes related to mental health services to streamline and update the state's approach to mental health coverage.

Budget and Finance, Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=1432&Year=2025&Initiative=false