HB 653 – Mental Health & SUD Parity Report
Primary House Sponsors: Rep. Carla Cunningham (D-Mecklenburg); Rep. Donny Lambeth (R-Forsyth); Rep. Kristin Baker, MD (R-Cabarrus); Rep. Gale Adcock (D-Wake)
Summary
This bill requires insurers offering health benefit plans in the State to submit an annual mental health and substance use disorder parity report to the Commissioner of the Department of Insurance and to the Joint Legislative Oversight Committee on Health and Human Services.
This bill also specifies the information required to be included within the report including: (1) rates of utilization review for mental health and substance use disorder claims compared to medical and surgical claims; (2) the number of concurrent authorization requests for mental health and substance use disorder services and the number of denials for those requests, compared with the number of prior or concurrent authorization requests for medical and surgical services and the number of denials for those requests; (3) the rates of appeals of adverse determinations for mental health and substances use disorder claims compared with the rates of appeals of adverse determinations for medical and surgical claims; (4) the percentage of claims paid for out-of-network mental health and substance use disorder services compared with the percentage of claims paid for out-of-network medical and surgical services; (5) the percentage of claims paid for in-network mental health and substance use disorder services compared with the percentage of claims paid for in-network medical and surgical services; (6) a comparison of the cost-sharing requirements and the benefit limitations for mental health and substance use disorder services with the same cost-sharing requirements and benefit limitations for medical and surgical services; (7) the number of in-network providers that provide services for the treatment and diagnosis of substance use disorder and the number of in-network providers that provide services for the diagnosis and treatment of mental health disorders; and (8) any other data or information the Commissioner determines is necessary to measure compliance with mental health and substance use disorder parity laws.
Movement
Filed – 4/22/2021