Bill > AB338

This bill requires health insurance policies and self-insured governmental health plans that provide mental health or behavioral health services to cover at least 28 appointments or visits with a mental health care provider per policy year, or as many visits as necessary to meet the patient's treatment goals. The bill prohibits these plans from requiring prior authorization for such mental health services, which means patients can access these appointments without needing advance approval from their insurance company. The Office of the Commissioner of Insurance must conduct a preliminary actuarial estimate to determine the potential cost impact of these new coverage requirements on qualified health plans. If this estimate shows that the coverage would increase average costs by more than 10 percent, the Office of the Commissioner of Insurance would be prevented from enforcing the new mental health service coverage requirements. The bill applies to various types of health plans, including disability insurance policies, limited service health organizations, preferred provider plans, and defined network plans. The new requirements will take effect for policy or plan years beginning on the first day of the fourth month after the bill's publication, with special considerations for existing collective bargaining agreements that may have conflicting provisions.

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https://docs.legis.wisconsin.gov/2025/proposals/reg/asm/bill/ab338