Rhode Island H7945 mandates that payors use criteria reflecting generally accepted standards of care for mental health and substance use disorder.

Rhode Island H7945 requires payors to rely on criteria reflecting generally accepted standards of care when developing coverage for mental health and substance use disorder treatment. Payors must use the most recent age-appropriate patient placement criteria from nonprofit professional provider associations. The act prohibits modifying clinical criteria to reduce coverage below these standards and mandates that non-quantitative treatment limitations be comparable to those applied to other medical conditions.

Rhode Island H7945 mandates that payors use criteria reflecting generally accepted standards of care for mental health and substance use disorder.

Rhode Island H7945 requires payors to rely on criteria reflecting generally accepted standards of care when developing coverage for mental health and substance use disorder treatment. Payors must use the most recent age-appropriate patient placement criteria from nonprofit professional provider associations. The act prohibits modifying clinical criteria to reduce coverage below these standards and mandates that non-quantitative treatment limitations be comparable to those applied to other medical conditions.