Nonquantitative treatment limitations.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Enrolled
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill aims to ensure that health insurance plans and insurers don't use unfair or overly restrictive rules to limit mental health and substance use disorder benefits compared to other medical treatments. It requires plans and insurers to collect and analyze data to show that these limitations aren't more restrictive than those applied to other medical services, and to regularly report their findings to state agencies. The bill also seeks to clarify definitions and strengthen enforcement of existing parity laws.
Key provisions
- Prohibits discriminatory factors and evidentiary standards in designing nonquantitative treatment limitations (NQTLs) for mental health and substance use disorder benefits.
- Requires health care service plans and insurers to collect and evaluate data to assess the impact of NQTLs on access to mental health and substance use disorder benefits.
- Mandates comparative analyses of NQTLs, comparing them to those applied to medical/surgical benefits.
- Requires plans and insurers to submit these comparative analyses to state departments annually.
- Defines key terms related to mental health, substance use disorder, and medical/surgical benefits.
- Addresses historical data to ensure it’s not used to perpetuate discriminatory practices.
- Requires plans and insurers to notify enrollees if they are found to be in noncompliance with parity requirements.
- Deems NQTLs a violation of parity if a final determination of noncompliance is made.
Bill text
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