Michigan Legislation

HB 6190 amends the MCL to prohibit insurers from placing cost sharing requirements and benefit or service limitations on outpatient and inpatient mental health services that place a greater financial burden on a beneficiary or are more restrictive than those for medical services. It also amends MCL 500.100-500.8302 by adding section 500.346u to apply the above to insurance policies or insurance contracts that insure against loss resulting from sickness or from bodily injury or death by accident, or both, including specific hospital benefits and medical, surgical, and sick-care benefits to an individual, family, or group.

HB 6191 amends 1980 PA 350 (MCL 550.1101 to 550.1704) by adding section 550.416f to prohibit health care corporations that issue or renew group or nongroup certificates from placing cost sharing requirements and benefit or service limitations on outpatient and inpatient mental health services that place a greater financial burden on a beneficiary or are more restrictive than those for medical services

• Requires plans to structure their in-network coverage for autism services so that plan enrollees can receive “timely” diagnosis and treatment (“timely” is defined precisely)
• Plans cannot deny or limit coverage to a child with “problem behaviors”
• Requires the Department of Insurance and Financial Services to adjust the annual maximums for inflation every year

This bill tried to add a section to the state insurance law about parity. It would have required plans that cover inpatient care, outpatient care, and residential treatment for behavioral health conditions (including autism) to have financial requirements and treatment limitations similar to and no more “restrictive” than those in place for other medical services.

• No age-specific requirements or age limits for treatment
• Required annual maximum of $50,000 for all who are covered (specifies that this is for applied behavior analysis)
• No language allowing plans to request that an autism diagnostic observation schedule be performed once every 3 years
• Does not specify how often a plan can review a child’s treatment plan
• No language about the Affordable Care Act

• No age-specific requirements or age limits for treatment
• Required annual maximum of at least $50,000 for all who are covered (specifies that this is for applied behavior analysis)
• No language allowing plans to request that an autism diagnostic observation schedule be performed once every 3 years
• Does not specify how often a plan can review a child’s treatment plan
• No language about the Affordable Care Act

• Schizophrenia
• Schizoaffective disorder
• Bipolar disorder
• Major depressive disorder
• Paranoia and other psychotic disorders
• Obsessive compulsive disorder
• Panic disorder

• No age-specific requirements or age limits for treatment
• No language about annual maximums
• No language allowing plans to request that an autism diagnostic observation schedule be performed once every 3 years
• Plans can review a child’s treatment plan once every 6 months
• Does not list and define treatment of autism spectrum disorder (except for applied behavior analysis)
• No language about the Affordable Care Act

• No age-specific requirements or age limits for treatment
• Required annual maximum of at least $50,000 for all who are covered (specifies that this is for applied behavior analysis )
• No language allowing plans to request that an autism diagnostic observation schedule be performed once every 3 years
• Allows plans to review a child’s treatment plan once every 6 months
• No language about the Affordable Care Act

• No age-specific requirements or age limits for treatment
• Required annual maximum of at least $50,000 for all who are covered (specifies that this is for applied behavior analysis )
• No language allowing plans to request that an autism diagnostic observation schedule be performed once every 3 years
• No language about the Affordable Care Act