The bill amends the Michigan Insurance Code of 1956, specifically section 3425, to enhance coverage requirements for mental health and substance use disorder treatment. It mandates that insurers providing health insurance policies in Michigan must cover inpatient, intermediate, and outpatient care for mental health and substance use disorders that are deemed medically necessary. The bill also stipulates that the terms and conditions for this coverage must be at least as favorable as those for other comparable services, and it prohibits insurers from imposing less favorable terms on mental health and substance use disorder coverage compared to other types of coverage.

Additionally, the bill introduces new definitions and clarifications regarding clinical review criteria, generally accepted standards of care, and what constitutes medically necessary services. It emphasizes that utilization review and clinical review criteria for mental health and substance use disorders must align with established standards in the field. The bill also retains the existing definitions of limited classification policies while updating the language to reflect current practices and standards in mental health care.

Statutes affected:
House Introduced Bill: 500.3425