Bill > SB5477

This bill aims to improve access to mental health and substance use disorder services by updating Washington's mental health parity law. It introduces several key provisions that require health carriers to modify their approach to mental health and substance use disorder treatment. The bill establishes comprehensive definitions for terms like "medically necessary" and "generally accepted standards of care," which must be based on scientific evidence and recommendations from professional associations. It mandates that health plans reduce administrative barriers by implementing more streamlined prior authorization processes, with specific time frames for making decisions about mental health treatment requests. The bill requires health carriers to base medical necessity determinations on objective patient needs and prohibits carriers from making coverage decisions primarily for economic benefits. Additionally, the legislation expands the diagnostic categories covered for mental health services, including provisions to recognize emerging medical classifications by 2026. The bill also gives the insurance commissioner authority to adopt rules ensuring consistent utilization review and parity in mental health treatment coverage. Notably, the bill will take effect on January 1, 2026, and will repeal several existing statutes related to mental health service definitions, signaling a comprehensive update to the state's approach to mental health insurance coverage.

Health and Social Services

https://app.leg.wa.gov/billsummary?BillNumber=5477&Year=2025&Initiative=false