HB 710 Summary

• Amends insurance nondiscrimination provisions to require health insurers, mutual benefit societies, and health maintenance organizations to consider the most recent World Professional Association for Transgender Health (WPATH) Standards of Care when determining medical necessity for gender affirming care services.

• Prohibits denying coverage for gender affirming care services on the basis that gender identity is classified as a behavioral health condition.

• Requires that any denial of gender affirming care coverage based on being cosmetic or not medically necessary include: (1) the training and expertise of individuals who made the determination, and (2) a plain language explanation specific to the person requesting coverage.

• Mandates that appeals of denied gender affirming care claims be reviewed for medical necessity by a health care provider or mental health professional with current experience in prescribing or delivering gender affirming care services, with the same detailed explanation requirements for uphold denials.

• Requires insurance carriers to make clear information about gender affirming care coverage and medical necessity requirements publicly available on their websites.