SB2362 Summary

• Requires all health insurers offering group or individual policies, qualified health plans, and Medicaid managed care organizations to provide coverage for medically necessary treatment of vision, hearing, and dental disorders or conditions effective January 1, 2024.

• Establishes parity requirements ensuring financial requirements and treatment limitations for vision, hearing, and dental benefits are no more restrictive than those for other medical benefits, with rules governing aggregate lifetime and annual limits.

• Sets procedures for medical necessity determinations, plan information availability, notifications, and external review rights when insurers deny coverage as no longer medically necessary.

• Imposes civil penalties of $1,000-$5,000 per violation and establishes a Class A misdemeanor offense with 30-day cure period for insurers that violate the new requirements after receiving notice.

• Requires insurers to conduct interrater reliability testing, maintain staff education programs, track utilization review criteria usage, and submit annual parity compliance reports to the Department of Insurance.