FL S1536

Requires Medicaid managed care plans to submit annual reports by July 1 detailing medical necessity criteria, nonquantitative treatment limitations (NQTLs), and analyses demonstrating parity between mental/substance use disorder benefits and medical/surgical benefits.

Mandates all insurers, HMOs, and nonprofit health plans transacting individual or group health insurance comply with the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and related federal regulations.

Eliminates previous optional coverage provisions for mental and nervous disorders and replaces them with mandatory parity requirements ensuring mental/nervous disorder and substance use disorder benefits receive treatment no less favorable than medical and surgical benefits.

Requires insurers to submit annual parity reports to the Office of Insurance Regulation by July 1 containing medical necessity criteria descriptions, NQTL identifications, and compliance analysis demonstrating no separate or more stringent limitations apply to mental health or substance use benefits.

Directs the Office of Insurance Regulation to enforce MHPAEA compliance through market conduct examinations, complaint reviews, and network adequacy checks, with the office issuing an annual public report to the Legislature by December 31 describing compliance methodologies and findings.