SB1157 Summary

• Director shall implement and enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and related federal regulations (45 CFR 146.136, 147.136, 147.160, and 156.115(a)(3)) for all health insurers operating in Michigan.

• Director must proactively ensure compliance by any insurer that delivers, issues, or renews health insurance policies in the state.

• Director shall evaluate all consumer and provider complaints regarding mental health and substance use disorder coverage for potential parity violations.

• Director must conduct market conduct examinations of insurers focusing on nonquantitative treatment limitations including prior authorization, concurrent review, step therapy, network admission standards, reimbursement rates, and geographic restrictions.

• Insurers must submit comparative analyses during form review demonstrating how nonquantitative treatment limitations are designed and applied for mental health and substance use disorder benefits compared to medical and surgical benefits.