Insurance: health insurers; coverage for intermediate and outpatient care for substance use disorder; modify. Amends secs. 2212e & 3425 of 1956 PA 218 (MCL 500.2212e & 500.3425).
Impact
The bill is expected to significantly impact state laws related to health care accessibility, particularly for mental health and substance use disorder treatments. By imposing more stringent rules on how prior authorizations must be handled, including deadlines for approvals and requirements for clarity in communication, HB4707 aims to enhance patient care practices. It seeks to prevent delays in treatment caused by cumbersome authorization procedures, thereby promoting timely access to necessary care.
Summary
House Bill 4707 aims to amend sections of the Insurance Code of 1956 to improve coverage for intermediate and outpatient care for substance use disorders and mental health treatment. The bill mandates that health insurers provide coverage in alignment with recognized standards of care, ensuring that individuals suffering from these disorders receive necessary treatment without unnecessary hindrances. It introduces specific requirements for insurers regarding prior authorization processes for treatments, emphasizing the use of standard electronic transaction processes to simplify and expedite approvals.
Contention
Noteworthy points of contention surrounding HB4707 include the potential challenges faced by insurance companies in adapting their existing processes to comply with the new standards. Some stakeholders argue that while the intent of improving patient access to treatment is commendable, the implementation of standardized practices will require significant operational adjustments and may strain resources. Additionally, there are concerns about how these changes will affect the scope of coverage and the financial implications for insurers that may need to absorb higher costs if claims processes become more expensive under the new regulations.
Insurance: health insurers; coverage for intermediate and outpatient care for substance use disorder; modify. Amends secs. 2212e & 3425 of 1956 PA 218 (MCL 500.2212e & 500.3425).
Insurance: health insurers; prior authorization requirements for mental health and substance use disorder; modify. Amends sec. 3425 of 1956 PA 218 (MCL 500.3425).
Insurance: health insurers; health insurance policy; include provision related to Michigan health insurance exchange act. Amends sec. 2212a of 1956 PA 218 (MCL 500.2212a). TIE BAR WITH: SB 0633'23
Insurance: health insurers; equitable coverage for behavioral health and substance use disorder treatment; provide for. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406hh.
Insurance: health insurers; coverage for intermediate and outpatient care for substance use disorder; modify. Amends secs. 2212e & 3425 of 1956 PA 218 (MCL 500.2212e & 500.3425).
Outlines the insurance coverage standards, protocols and guidelines for medically necessary treatment of individuals with mental health or substance abuse use disorders.