HB5077

Advances mental health and substance use disorder coverage in insurance policies.

Requires insurance policies to cover medically necessary treatment of mental health and substance use disorders. Mandates that insurers follow generally accepted standards when making medical necessity determinations and prohibits discretionary clauses. Insurers must arrange for medically necessary out-of-network services if in-network options are unavailable. Insurers must also sponsor education programs for staff and providers on clinical review criteria.