Exclusions based on failure to complete a course of (g) treatment; and Restrictions based on geographic location, facility type, (h) provider specialty, and other criteria that limit scope or duration of benefits. All health plan standards must comply with the parity WAC requirement. Includes: in-and-out-of-network geographic limitations, limitations on inpatient services for situations where the participant is a threat to self or others, exclusions for court-ordered and involuntary holds, experimental treatment limitations, service coding, exclusions for services provided by clinical social workers, and network adequacy. If a health plan or issuer classifies providers into and varies WAC cost-sharing based on the different tiers, there must not be any financial requirement or treatment limitation on MH/SUD benefits that is more restrictive than what applies to WAC substantially all medical/surgical benefits in that tier.
(g) Exclusions based on failure to complete a course of treatment; and (h) Restrictions based on geographic location, facility type, provider specialty, and other criteria that limit scope or duration of benefits. WAC All health plan standards must comply with the parity requirement. Includes: in-and-out-of-network geographic limitations, limitations on inpatient services for situations where the participant is a threat to self or others, exclusions for court-ordered and involuntary holds, experimental treatment limitations, service coding, exclusions for services provided by clinical social workers, and network adequacy. WAC WAC If a health plan or issuer classifies providers into and varies cost-sharing based on the different tiers, there must not be any financial requirement or treatment limitation on MH/SUD benefits that is more restrictive than what applies to substantially all medical/surgical benefits in that tier.