Bill > S643

This bill aims to establish a more comprehensive process for evaluating and implementing mandated health benefits, which are requirements for health insurance to cover specific services, diseases, or providers. It introduces the concept of "flexible health benefit policies" that may not include all state-mandated benefits, but requires insurers offering these to also provide an option for a policy that covers all mandated benefits. The bill mandates that before any new mandated health benefit is proposed by legislative committees or state agencies, the Division of Health Care Finance and Policy (DHCFP) must conduct a thorough review and evaluation of its financial and medical impact, with specific timelines for these reviews to be completed. This evaluation will consider factors like cost increases, changes in service utilization, effects on healthcare providers, and the overall impact on the healthcare system and consumers. The bill also clarifies that certain essential health benefits, such as coverage for pregnant women, infants, children, prenatal care, diabetes-related services, and mental health services, must still be included in approved health insurance policies, even if other mandated benefits are not.