Treatment 2008 (“MHPAEA”)) (EHB) The copayment or coinsurance for mental health services RCW 48.20.580 (Cont’d) may be no more than the copayment or coinsurance for (2)(a) medical and surgical services otherwise provided the health benefit plan. Preventive services are excluded from this comparison. If the plan has a maximum out-of-pocket limit or stop loss, it RCW 48.20.580 must be for medical, surgical, and mental health - it cannot (2)(a) have a separate MOOP or stop loss for mental health. If the plan has any deductible, it must be for medical, surgical, and mental health – it cannot have a separate deductible for mental health. Prescription drugs intended to treat any MH/SUD disorder RCW 48.20.580 must be covered to the same extent, and under the same (2)(b) terms and conditions, as other covered prescription drugs. Health benefit plans may not reduce the number of mental RCW health outpatient visits or mental health inpatient days below 48.20.580(4) the level in effect on July 1, 2002. Plan must cover MH/SUD benefits in every classification in WAC which medical/surgical benefits are provided. 6 Classifications: Inpatient, in-network; inpatient, WAC outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs. Outpatient services &(6)(a)(i)(ii) may be 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
Treatment (EHB) (Cont’d) 2008 (“MHPAEA”)) RCW 48.20.580 (2)(a) The copayment or coinsurance for mental health services may be no more than the copayment or coinsurance for medical and surgical services otherwise provided the health benefit plan. Preventive services are excluded from this comparison. RCW 48.20.580 (2)(a) 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. 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 48.20.580 (2)(b) Prescription drugs 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 48.20.580(4) 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, 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
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