Providing continuity of care for mental health treatment
Impact
The implementation of HB 936 is expected to significantly impact state laws governing mental health treatment coverage. It mandates that insurance carriers permit insured individuals engaged in a continuing course of treatment to continue their care with their current provider even if that provider becomes out-of-network, provided the disenrollment is not due to quality issues or fraud. This provision aims to reduce gaps in care that can negatively affect treatment outcomes, emphasizing the importance of maintaining established patient-provider relationships.
Summary
House Bill 936 aims to improve continuity of care for mental health treatment by amending existing laws regarding insurance coverage. By defining 'continuing course of treatment' as having at least one visit in the past four months for the same or similar mental health condition, the bill provides clear criteria to ensure that insured individuals can continue their treatment without interruption. This is particularly important for patients whose providers may be involuntarily disenrolled from their insurance plans or when changes in insurance carriers occur.
Contention
While supporters of the bill argue that it is a necessary step in safeguarding mental health care access, there are concerns regarding potential financial implications for insurance companies. Some opponents may question the feasibility of mandatory reimbursements to out-of-network providers at the usual network rate, which could increase costs for insurers. Additionally, there could be debates surrounding the adequacy of payment structures and the definition of 'usual network rate', potentially leading to legal and regulatory challenges as the bill is implemented.