Bill > S512

This bill aims to increase transparency for mental health parity by requiring health insurance carriers to provide specific information when denying coverage for mental health services, which includes behavioral health and substance abuse disorder services. When a denial occurs, the carrier must issue a statement to the insured, or their representative, certifying that the denial complies with state laws requiring coverage for mental health services to be provided without discrimination, referencing Chapter 80 of the Acts of 2000. This statement must also detail any quantitative (measurable) and non-quantitative (non-measurable) treatment limitations used in the review process and explain how these limitations meet state and federal parity regulations, including those found in 42 U.S. Code § 300gg–26, and state regulations. Finally, the carrier must certify that their claim processing and utilization review methods adhered to these parity requirements.