Bill
HB 1134
Indiana HB 1134 expands coverage to include certain out-of-network mental health and substance use treatments and requires annual NQTL reporting by insurers.
Title: Insurance for mental health and substance use
Jurisdiction: Indiana
Purpose and intent
- Amend the definition of “treatment of a mental illness or substance abuse” for certain provisions of Indiana law.
- Goal appears to strengthen and clarify parity requirements and reporting related to coverage for mental health and substance use treatment, including services provided by certain out-of-network providers.
Effective date
- July 1, 2026
Key provisions and changes
1) Redefinition of “treatment of a mental illness or substance abuse” (IC 27-8-5-15.8 and IC 27-13-7-14.2)
- The bill expands the scope of what counts as treatment for mental illness or substance abuse to include:
- Treatment for mental illness (as defined in IC 12-7-2-130(1)).
- Treatment for drug abuse or alcohol abuse.
- The definition explicitly includes treatment provided by:
- Mental health counselor associates (IC 25-23.6)
- Social workers licensed under IC 25-23.6
- Marriage and family therapist associates (IC 25-23.6-8-1.5)
- Clinical addiction counselor associates (IC 25-23.6)
- Interns or trainees pursuing study toward medicine or psychology or licensure under IC 25-23.6
- This inclusion applies regardless of network status (in-network or out-of-network, as defined by IC 27-1-46-4).
2) Reporting and compliance requirements related to nonquantitative treatment limitations (NQTLs)
- Insurers issuing accident and sickness policies that cover mental health or substance abuse must annually report to the Indiana Department of Insurance (DOI) by December 31:
- Description of processes used to develop medical necessity criteria for:
- Mental health/substance abuse services
- Other medical/surgical conditions
- Identification of all NQTLs applied to mental health/substance abuse and to other medical/surgical conditions, within each classification of benefits
- A statement that no separate NQTLs apply to mental health/substance abuse that do not also apply to other conditions within any classification of benefits
- Insurers must also submit an analysis of compliance with these requirements by December 31:
- Identify factors used to determine when an NQTL applies, including rejected factors
- Define evidentiary standards used for those factors and any other evidence relied upon
- Provide comparative analyses showing:
- The design processes for NQTLs for mental health/substance abuse are comparable to those for other conditions (no stricter standards)
- The application of NQTLs for mental health/substance abuse is not more stringent than for other conditions
- DOI to adopt rules to ensure compliance
3) Parallel provisions for individual or group contracts (IC 27-13-7-14.2)
- Similar reporting and analysis requirements as section 1, but applicable to contracts rather than insurance policies
- Requires annual submission by December 31 of each year with:
- Description of processes for medical necessity criteria (mental health/substance abuse vs. other conditions)
- Listing of all NQTLs and their application across benefit classifications
- Confirmation that no separate NQTLs apply only to mental health/substance abuse within classifications
- Compliance analysis comparing processes and application of NQTLs to those for other conditions
4) Department oversight
- The Indiana Department of Insurance (DOI) is responsible for adopting and enforcing rules to ensure compliance with these provisions.
Who is affected
Potential impact
Fiscal and administrative notes
Effective date for applicability: July 1, 2026.
Compiled from official sources — confirm details with the bill’s official record.
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