AN ACT TO REQUIRE THAT EVERY INSURANCE POLICY ISSUED, AMENDED, OR RENEWED ON OR AFTER JANUARY 1, 2026, THAT PROVIDES HOSPITAL, MEDICAL, OR SURGICAL COVERAGE TO PROVIDE COVERAGE FOR MEDICALLY NECESSARY TREATMENT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS; TO PROHIBIT INSURERS FROM LIMITING BENEFITS OR COVERAGE FOR CHRONIC OR PERVASIVE MENTAL HEALTH AND SUBSTANCE USE DISORDERS TO SHORT-TERM OR ACUTE TREATMENT AT ANY LEVEL OF CARE PLACEMENT; TO PROHIBIT INSURERS FROM LIMITING BENEFITS OR COVERAGE FOR MEDICALLY NECESSARY SERVICES ON THE BASIS THAT THOSE SERVICES SHOULD BE OR COULD BE COVERED BY A PUBLIC ENTITLEMENT PROGRAM; TO PROHIBIT INSURERS FROM ADOPTING, IMPOSING, OR ENFORCING TERMS IN ITS POLICIES OR PROVIDER AGREEMENTS THAT UNDERMINE, ALTER, OR CONFLICT WITH THE REQUIREMENTS OF THIS ACT; TO REQUIRE INSURERS TO USE CURRENT GENERALLY ACCEPTED STANDARDS OF MENTAL HEALTH AND SUBSTANCE USE DISORDER CARE TO DETERMINE THE MEDICAL NECESSITY OF HEALTH CARE SERVICES AND BENEFITS FOR THE DIAGNOSIS, PREVENTION, AND TREATMENT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS; TO REQUIRE INSURERS, IN CONDUCTING UTILIZATION REVIEW OF ALL COVERED HEALTH CARE SERVICES AND BENEFITS FOR THE DIAGNOSIS, PREVENTION, AND TREATMENT OF MENTAL HEALTH AND SUBSTANCE USE DISORDERS, TO APPLY THE LEVEL OF CARE PLACEMENT CRITERIA AND PRACTICE GUIDELINES SET FORTH IN THE MOST RECENT VERSIONS OF SUCH CRITERIA AND PRACTICE GUIDELINES, DEVELOPED BY THE NONPROFIT PROFESSIONAL ASSOCIATION FOR THE RELEVANT CLINICAL SPECIALTY; TO REQUIRE INSURERS TO TAKE CERTAIN ACTIONS TO ENSURE THE PROPER USE OF THE CRITERIA DESCRIBED IN THE PRECEDING PROVISION; TO PROVIDE THAT IF AN INSURER CONTRACT CONTAINS A PROVISION THAT RESERVES DISCRETIONARY AUTHORITY TO THE INSURER TO DETERMINE ELIGIBILITY FOR BENEFITS OR COVERAGE, TO INTERPRET THE TERMS OF THE CONTRACT, OR TO PROVIDE STANDARDS OF INTERPRETATION OR REVIEW THAT ARE INCONSISTENT WITH THE LAWS OF THIS STATE, THAT PROVISION IS VOID AND UNENFORCEABLE; TO AUTHORIZE THE COMMISSIONER OF INSURANCE TO ASSESS CIVIL PENALTIES AGAINST INSURERS FOR EACH VIOLATION OF THIS ACT; TO AMEND SECTIONS 41-83-31, 83-9-27, 83-9-39, 83-9-41 AND 83-9-43, MISSISSIPPI CODE OF 1972, TO CONFORM TO THE PRECEDING PROVISIONS; TO BRING FORWARD SECTIONS 83-9-29, 83-9-31 AND 83-9-37, MISSISSIPPI CODE OF 1972, WHICH RELATE TO INSURANCE COVERAGE FOR TREATMENT OF ALCOHOLISM AND MENTAL ILLNESS, FOR THE PURPOSES OF POSSIBLE AMENDMENT; AND FOR RELATED PURPOSES.

Statutes affected:
As Introduced: 41-83-31, 83-9-27, 83-9-29, 83-9-31, 83-9-37, 83-9-39, 83-9-41, 83-9-43