AB 1149

This bill requires health insurance policies and self-insured governmental

health plans that provide coverage of mental health or behavioral health items or

services to cover in each policy year at least 28 appointments or visits with a mental

health care provider to treat mental health or substance use disorders or as many

appointments or visits with a mental health care provider as are necessary to meet

the insured's treatment goals. The bill prohibits health insurance policies and

self-insured governmental health plans from requiring prior authorization for the

coverage of appointments or visits under the bill. Health insurance policies are

known as disability insurance policies in the bill. Further, this bill requires the

Office of the Commissioner of Insurance to prepare a preliminary actuarial estimate

of the average cost for all qualified health plans, as defined under federal law,

attributable to the coverage required under the bill. If the preliminary actuarial

estimate of the average cost for all qualified health plans is an increase of greater

than 10 percent, OCI may not enforce the coverage requirements under the bill.

This proposal may contain a health insurance mandate requiring a social and

financial impact report under s. 601.423, stats.