Health care coverage for mental health and substance use disorders.
Vote required
Majority
Fiscal committee
No
Appropriation
No
Current location
Health
Take action
Record your position on this measure.
Create an account to record your position, submit testimony, or contact your legislator.
Progress
Where this bill stands in the legislative process.
- Introduced
- Passed Senate
- Passed Assembly
- To Governor
- Became Law
Overview
This bill aims to improve health care coverage for mental health and substance use disorders by requiring health care service plans and disability insurers to provide the same level of coverage as for other medical conditions. It mandates that plans arrange for out-of-network care when necessary and prohibits excessive cost-sharing for non-contracting health professionals providing these services. The bill also establishes specific reimbursement rates for out-of-network providers and ensures clear communication with enrollees about costs.
Key provisions
- Requires health care service plans and disability insurers to cover mental health and substance use disorders under the same terms as other medical conditions.
- Mandates arrangements for out-of-network care when necessary, ensuring access to medically necessary services.
- Prohibits excessive cost-sharing for non-contracting health professionals providing out-of-network services.
- Establishes specific reimbursement rates for out-of-network providers (the greater of the average contracted rate or 125% of Medicare reimbursement).
- Requires clear communication to enrollees about costs and prohibits billing practices that are misleading.
- Prohibits plans from limiting benefits for mental health and substance use disorders to short-term or acute treatment.
- Addresses how plans should handle disputes with providers regarding billing and claims.
- Updates existing law to align with current diagnostic classifications for mental and behavioral disorders.
Bill text
Read the latest version inline or switch to a previous version.
Text extraction is in progress. View the official source.
Sponsors
Official sponsors from legislative records.
1 on record
Primary sponsor
Arguments
Reasons offered for and against this legislation.
Arguments in favor
No arguments in favor have been submitted.
Submit yoursArguments opposed
No arguments opposed have been submitted.
Submit yours