Bill > SB524

This bill aims to improve access to and oversight of mental health and substance abuse disorder care by strengthening network adequacy standards, requiring more detailed comparative analyses from health carriers, and enhancing reporting requirements. Specifically, it directs the Department of Health to establish quantitative network adequacy standards for timely access to care, travel time, and geographical distance that are at least as stringent as those for qualified health plans and qualified dental plans, which are plans that meet federal requirements for health insurance coverage. The bill also clarifies the definitions of "mental health services" and "substance abuse services" to ensure broader coverage. Health carriers will now be required to submit all comparative analyses, which are reports comparing how they manage medical and surgical benefits versus mental health and substance use disorder benefits, to the Bureau of Insurance, which is part of the State Corporation Commission that regulates insurance. The Bureau can impose penalties of up to $100,000 for noncompliant analyses or require carriers to fix inadequate treatment limitations. Furthermore, the annual report from the Bureau to the General Assembly will now include details on enforcement efforts related to the federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), a law requiring parity in coverage between mental health/substance use disorder benefits and medical/surgical benefits. The bill also authorizes the Bureau and directs the Department of Health to issue emergency regulations to implement these changes.

Budget and Finance, Health and Social Services

https://lis.virginia.gov/bill-details/20261/SB524