Bill > H6061

This bill amends existing insurance laws to strengthen mental health and substance use disorder coverage by requiring insurance providers to develop coverage criteria based on "generally accepted standards of care," which are defined as standards recognized by healthcare providers in relevant clinical specialties. The bill mandates that insurers cannot modify clinical criteria in a way that reduces mental health treatment coverage below these established standards, ensuring that patients receive comprehensive and appropriate care. The legislation also clarifies definitions related to mental health and substance use disorder treatments, expands the understanding of acceptable care standards by referencing sources like clinical practice guidelines, patient placement criteria, and federal agency recommendations. Key provisions include maintaining parity between mental health and medical health coverage, ensuring no annual or lifetime dollar limitations on mental health treatments, and requiring that financial requirements and treatment limitations for mental health services be no more restrictive than those for medical conditions. The bill aims to prevent insurance companies from implementing overly restrictive policies that could limit access to necessary mental health and substance use disorder treatments, ultimately protecting patients' ability to receive adequate and appropriate care.

Health and Social Services

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