The bill seeks to improve access to mental health and substance use disorder services in Washington by updating the state's mental health parity law. It mandates that health insurance coverage for these services aligns with generally accepted standards of care, requiring health plans to cover medically necessary treatments without imposing discriminatory limitations. Key provisions include the alignment of clinical review criteria with established standards, the prohibition of coverage denial based on the assumption that services could be covered by public programs, and the establishment of a streamlined independent review process for disputes regarding health care coverage decisions.

Additionally, the bill introduces new requirements for the prior authorization process for prescription drugs, mandating the implementation of an interoperable electronic system by January 1, 2027, to automate prior authorization determinations. It also includes provisions for the insurance commissioner to adopt necessary rules for compliance with parity standards and repeals several existing laws related to mental health services coverage effective January 1, 2027. Importantly, the act will become null and void if specific funding is not provided by June 30, 2025, emphasizing the need for timely updates to the legislature regarding federal rule developments that may impact the prior authorization process.

Statutes affected:
Original Bill: 48.43.016, 48.43.091, 48.43.410, 48.43.520, 48.43.535, 48.43.761, 48.43.830
Substitute Bill: 48.43.016, 48.43.410, 48.43.520, 48.43.530, 48.43.535, 48.43.600, 48.43.761, 48.43.830
Second Substitute: 48.43.016, 48.43.410, 48.43.520, 48.43.530, 48.43.535, 48.43.600, 48.43.761, 48.43.830
Engrossed Second Substitute: 48.43.016, 48.43.410, 48.43.520, 48.43.530, 48.43.535, 48.43.600, 48.43.830
Bill as Passed Legislature: 48.43.016, 48.43.410, 48.43.520, 48.43.535, 48.43.600, 48.43.830
Session Law: 48.43.016, 48.43.410, 48.43.520, 48.43.535, 48.43.600, 48.43.830