(Cont’d) RCW Mental 48.44.341 If the plan has a maximum out-of-pocket limit or stop loss, it Health (2)(c)(i) Parity must be for medical, surgical, and mental health - it cannot have (Cont’d) a separate MOOP or stop loss for mental health. RCW 48.44.341 If the plan has any deductible, it must be for medical, surgical, (2)(c)(i) and mental health – it cannot have a separate deductible for mental health. RCW 48.44.341 Prescription intended to treat any MH/SUD disorder must (2)(c)(ii) be covered to the same extent, and under the same terms and conditions, as other covered prescription drugs. RCW 48.44.342 No preauthorization for mental health treatment rendered by a state hospital if the enrollee or covered dependent is involuntarily committed. Health benefit plans may not reduce the number of mental health RCW outpatient visits or mental health inpatient days below the level in 48.44.341(3) effect on July 1, 2002. Plan must cover MH/SUD benefits in every classification in which WAC medical/surgical benefits are provided. 6 Classifications: Inpatient, in-network; inpatient, out-of-network; WAC outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs. Outpatient services may be &(6)(a)(i)(ii) subclassified into office visits and all other outpatient items and services. In determining the classification in which a particular benefit WAC belongs, a plan must apply the same standards to medical/surgical benefits as applied to MH/SUD benefits. An issuer must assign covered intermediate MH/SUD benefits such as residential treatment, partial hospitalization, and intensive outpatient treatment, to the existing six classifications in the same
(Cont’d) Mental Health Parity (Cont’d) RCW 48.44.341 (2)(c)(i) If the plan has a maximum out-of-pocket limit or stop loss, it must be for medical, surgical, and mental health - it cannot have a separate MOOP or stop loss for mental health. RCW 48.44.341 (2)(c)(i) If the plan has any deductible, it must be for medical, surgical, and mental health – it cannot have a separate deductible for mental health. RCW 48.44.341 (2)(c)(ii) Prescription intended to treat any MH/SUD disorder must be covered to the same extent, and under the same terms and conditions, as other covered prescription drugs. RCW 48.44.342 No preauthorization for mental health treatment rendered by a state hospital if the enrollee or covered dependent is involuntarily committed. RCW 48.44.341(3) Health benefit plans may not reduce the number of mental health outpatient visits or mental health inpatient days below the level in effect on July 1, 2002. WAC Plan must cover MH/SUD benefits in every classification in which medical/surgical benefits are provided. WAC &(6)(a)(i)(ii) 6 Classifications: Inpatient, in-network; inpatient, out-of-network; outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs. Outpatient services may be subclassified into office visits and all other outpatient items and services. WAC In determining the classification in which a particular benefit belongs, a plan must apply the same standards to medical/surgical benefits as applied to MH/SUD benefits. An issuer must assign covered intermediate MH/SUD benefits such as residential treatment, partial hospitalization, and intensive outpatient treatment, to the existing six classifications in the same