On August 12, 2021, Commissioner Mulready issued LH Bulletin No. 2021-03. This bulletin reminds carriers and plans that federal and state law require that health benefit plans that cover physical diseases and disorders shall provide equal benefits for mental health and substance use disorders that are subject to the same preauthorization and utilization review mechanisms unless otherwise exempted by statute.
In addition, the bulletin notes that current state law also limits coverage for Applied Behavioral Analysis to a maximum benefit of twenty-five hours per week and no more than $25,000 per year. The Insurance Department advises that these limitations conflict with state and federal mental health parity laws, and that the mental health parity laws control.
Employers with plans subject to the state’s regulation should be aware of this bulletin and make any amendments to their plans necessary to comply with this bulletin and current mental health parity law.
LH Bulletin No. 2021-03 »
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