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Senate Bill (S)

DIGEST

Compliance with coverage parity requirements. Requires an insurer that issues a policy of accident and sickness insurance or a health maintenance organization contract that provides coverage of services for treatment of a mental illness or substance abuse to annually submit a report and analysis to the department of insurance (department) that includes certain information demonstrating its compliance with federal laws regarding parity in coverage of services for treatment of a mental illness or substance abuse and coverage of services for treatment of other medical or surgical conditions, including the processes used: (1) to develop medical necessity criteria for coverage of Compliance with coverage parity requirements. Requires an insurer that issues a policy of accident and sickness insurance or a health maintenance organization contract that provides coverage of services for treatment of a mental illness or substance abuse to annually submit a report and analysis to the department of insurance (department) that includes certain information demonstrating its compliance with federal laws regarding parity in coverage of services for treatment of a mental illness or substance abuse and coverage of services for treatment of other medical or surgical conditions, including the processes used: (1) to develop medical necessity criteria for coverage of services; and (2) to develop and apply nonquantitative treatment limitations. Requires an insurer that issues a policy of accident and sickness insurance or a health maintenance organization contract that provides coverage for services for treatment of substance abuse to take certain actions with respect to prescription drugs approved for the treatment of substance abuse. Requires the department to adopt rules to ensure compliance with federal laws regarding parity in coverage. Requires the department to submit before March 1, 2021, a report to the general assembly detailing the steps taken to ensure insurers' compliance with state and federal laws regarding parity in coverage. ... View more