This bill mandates that, by January 1, 2027, all individual and group sickness and accident insurance policies, as well as self-funded employee benefit plans, must provide coverage for medically necessary treatments related to acquired brain injuries. The coverage must adhere to established clinical guidelines and cannot impose lifetime or annual limitations inconsistent with these standards. Additionally, the bill defines various terms related to brain injury treatment, including cognitive rehabilitation therapy and community reintegration services, and outlines that coverage for these services should not have greater deductibles or out-of-pocket limits than other benefits provided by the insurer.

Furthermore, the bill requires the Department of Insurance to establish rules for an expedited appeal process for adverse determinations regarding acquired brain injury services, ensuring that appeals are resolved within five business days. By January 1, 2028, the bill also mandates that insurance policies and Medicaid must cover all medically necessary diagnostic testing and treatments approved by the FDA to slow the progression of Alzheimer's disease and related dementias, with such coverage exempt from step-therapy requirements. The Department of Insurance is tasked with monitoring compliance and publishing annual reports on coverage determinations and appeals related to these services.