Assembly Bill 338 mandates that health insurance policies and self-insured governmental health plans in Wisconsin provide coverage for at least 28 appointments or visits with a mental health care provider each policy year for the treatment of mental health or substance use disorders. Additionally, the bill stipulates that these plans cannot require prior authorization for such appointments. The Office of the Commissioner of Insurance is tasked with preparing a preliminary actuarial estimate to assess the average cost impact of this coverage on qualified health plans. If this estimate indicates an increase of more than 10 percent, the enforcement of the coverage requirements will not proceed.

The bill introduces new sections to the statutes, specifically creating 609.865 and 632.895 (12g), which outline the coverage requirements and the role of the Office of the Commissioner of Insurance in evaluating the financial implications of the mandated coverage. The provisions will apply to policy or plan years beginning on the effective date of the bill, with specific considerations for policies affected by collective bargaining agreements. The act is set to take effect four months after its publication.