DE SB109

Extends mental health parity protections to Medicaid recipients by requiring carriers to provide coverage for serious mental illness and drug and alcohol dependencies without greater financial burden than other illnesses, including deductibles, copays, and visit limits.

Requires unlimited medically necessary treatment for substance use disorders in residential settings, intensive outpatient programs, and inpatient withdrawal management using the full American Society of Addiction Medicine (ASAM) criteria to determine medical necessity.

Prohibits concurrent utilization review during the first 14 days of inpatient admission, 30 days of intensive outpatient treatment, or 5 days of inpatient withdrawal management, provided facilities notify carriers within 48 hours and perform daily clinical reviews.

Eliminates precertification and prior authorization requirements for diagnosis and medically necessary treatment of drug and alcohol dependencies, allowing immediate access to emergency medication supplies.

Provides immediate access to 72-hour emergency supplies of prescribed medications without prior authorization for serious mental illness and substance use disorder treatment, including opioid overdose reversal medication.