Bill > AB2011

This bill aims to strengthen mental health parity laws by requiring health care service plans and insurers to ensure that any nonquantitative treatment limitations (NQTLs), which are restrictions on benefits not related to dollar amounts like prior authorization or medical necessity standards, are not more restrictive for mental health and substance use disorder benefits than for medical and surgical benefits. Specifically, it mandates that these entities collect and analyze data to assess the impact of NQTLs on access to care, conduct and document comparative analyses of how NQTLs are designed and applied to different types of benefits, and submit these analyses to state departments annually starting in 2027. If a plan or insurer is found to be noncompliant, they must notify all enrollees or insureds of the violation and may be directed by the relevant department to cease imposing the noncompliant NQTL. The bill also defines key terms like "medical/surgical benefits," "mental health benefits," and "substance use disorder benefits" and clarifies that discriminatory factors or evidentiary standards cannot be used to design NQTLs for mental health and substance use disorder benefits.

https://leginfo.legislature.ca.gov/faces/billStatusClient.xhtml?bill_id=202520260AB2011