The bill aims 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 must be on par with medical and surgical services, ensuring consistent treatment limitations and financial requirements. Key provisions include the establishment of clear criteria for utilization reviews, the requirement for health carriers to authorize care based on age-appropriate patient placement criteria, and the obligation to provide meaningful benefits for mental health conditions across all classifications of benefits. The bill also introduces penalties for non-compliance, including civil monetary penalties and mandates for health carriers to provide nonquantitative treatment limitation analyses upon request.

Additionally, the bill introduces new requirements for health insurance carriers regarding the prior authorization process, including specific timelines for making determinations and the need for clear communication of requirements based on peer-reviewed clinical criteria. It mandates the development of an application programming interface (API) to automate the prior authorization process, with implementation deadlines set for 2025 and 2027. The insurance commissioner is granted authority to adopt necessary rules for the act's implementation, including data testing for parity compliance. The bill also repeals several existing statutes related to mental health service coverage, effective January 1, 2026, and establishes a timeline for the overall implementation of the act.

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