Bill > SB42

This bill establishes new requirements for health insurance coverage and Medicaid related to perinatal mental health treatment. For commercial health insurance plans, the bill mandates coverage for voluntary inpatient treatment for individuals with a perinatal psychiatric diagnosis, which is defined as a mental health condition requiring inpatient treatment during pregnancy or within one year after giving birth (including pregnancy loss). The treatment decisions will be made solely by qualified healthcare providers in consultation with the patient, and these providers must consider evidence-based standards like InterQual or Milliman Care Guidelines. The bill requires that all levels of maternal mental health inpatient treatment be considered medically necessary and that health insurers cannot deny coverage that aligns with these standards. Similarly, Medicaid managed care organizations must also provide coverage for such voluntary inpatient treatments, with the same consultation and decision-making requirements. The provisions will apply to new health insurance policies issued on or after January 1, 2026, with existing policies required to conform by January 1, 2027. Importantly, the implementation of these provisions is subject to legislative appropriation of funds, meaning the actual execution depends on available funding.