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MI HB4683
Bill
Status
6/25/2025
Primary Sponsor
Mike McFall
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AI Summary
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Expands mandatory health insurance coverage for substance use disorder to include inpatient care, in addition to the existing intermediate and outpatient care requirements
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Adds mental health disorders to the mandatory coverage requirements alongside substance use disorder treatment
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Requires that utilization review and clinical review criteria for mental health and substance use disorders adhere to generally accepted standards of care in those fields
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Defines "medically necessary" treatment as services that align with generally accepted standards, are clinically appropriate in type/frequency/duration, and are not primarily for the insurer's economic benefit
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Establishes that coverage terms and conditions for mental health and substance use disorder treatment cannot be less favorable than those for comparable medical services
Legislative Description
Insurance: health insurers; prior authorization requirements for mental health and substance use disorder; modify. Amends sec. 3425 of 1956 PA 218 (MCL 500.3425).
Insurance: health insurers
Last Action
Bill Electronically Reproduced 06/25/2025
6/26/2025