Coverage of treatment for mental health or substance use disorders under health insurance policies and plans

What it would have done

Summary by the Legislative Reference Bureau, the Legislature's nonpartisan drafting office. It's their wording, not ours.

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.

Who's behind it

Melissa Agard, a Democrat, is its author⁠.

15 more lawmakers signed on in support⁠.