Substitute House Bill No. 7207 aims to improve transparency and accountability in the reporting of mental health and substance use disorder benefits by health carriers. The bill mandates that health carriers submit detailed reports to the Insurance Commissioner, which must include information on the processes used to assess medical necessity for both mental health and substance use disorder benefits, as well as medical and surgical benefits. A key insertion in the bill is the requirement for health carriers to disclose all evidentiary standards applied in their assessments and to provide comparative analyses demonstrating that nonquantitative treatment limitations for mental health benefits are applied comparably to those for medical and surgical benefits.

A significant change introduced by the bill is the classification of these reports as public records under the Freedom of Information Act (FOIA), which removes previous confidentiality provisions that protected the identities of health carriers. This shift allows the Insurance Commissioner to disclose the names of the carriers in the reports, promoting accountability and compliance with mental health parity laws. The effective date for this legislation is set for October 1, 2025, and it aligns with similar provisions found in related legislation, sSB 10, aimed at ensuring that mental health and substance use disorder benefits are treated comparably to medical and surgical benefits.

Statutes affected:
Raised Bill:
GAE Joint Favorable:
File No. 564: