Bill > S566

This bill updates North Carolina's laws regarding mental health and substance use disorder treatment coverage in health benefit plans, primarily by aligning state regulations with federal mental health parity laws. The legislation modifies existing statutes to enhance coverage for mental health and addiction recovery services by requiring health benefit plans to provide coverage for mental health conditions that is equivalent to coverage for physical health conditions. Key changes include updating terminology from "mental illness" to "mental health condition," expanding the definition of covered conditions, and ensuring that medical necessity determinations for mental health and substance use disorders are assessed using the same criteria as physical health conditions. The bill also requires that medical necessity for substance use disorders be determined solely using the most recent American Society of Addiction Medicine criteria and mandates that utilization review processes apply consistent clinical review standards across mental and physical health treatments. Additionally, the legislation updates various related statutes by replacing terms like "chemical dependency" with "substance use disorder" and repealing some outdated provisions. The changes will take effect on October 1, 2025, and will apply to insurance contracts issued, renewed, or amended on or after that date, with the goal of improving access to and parity of mental health and addiction treatment services.

https://www.ncleg.gov/BillLookUp/2025/S566