This bill mandates the Department of Banking and Insurance (DOBI) to conduct regular market conduct reviews, including secret shopper surveys, to evaluate access to mental health services for individuals aged 18 and younger. The reviews will assess network adequacy and appointment access standards across various populations, age groups, and geographic areas. Additionally, health insurance carriers are required to submit an annual report detailing usage rates for mental health services for minors, prior authorization requirements, denial of coverage requests, appeal outcomes, and approval rates for specialty services. The DOBI will analyze this data to identify barriers to necessary care and ensure compliance with mental health parity requirements.

Furthermore, the bill requires carriers to maintain an accurate and regularly verified provider directory, which must be presented in clear, accessible language on their websites and made available in a downloadable, machine-readable format. Carriers that fail to comply with these provisions will face penalties as outlined in the "Health Care Quality Act," which includes civil fines and potential cease-and-desist orders from the commissioner. The DOBI is also tasked with submitting an annual report to the Governor and Legislature, summarizing findings and recommendations based on the data collected, which will be publicly accessible on the department's website.

Statutes affected:
Introduced: 26:2S-10.8