Bill
A 3767
Bill Summary: A 3767 - Prohibits Retrospective Denial of Substance Use Disorder Treatment Payment SummaryThis bill, titled "Prohibits the retrospective denial of payment for substa
This bill, titled "Prohibits the retrospective denial of payment for substance use disorder treatment services," aims to protect individuals seeking treatment for substance use disorders (SUDs) by preventing insurance providers from retroactively denying coverage for necessary SUD treatment.
Prohibits Retrospective Denial of SUD Treatment Payment: The bill prohibits insurance providers from denying payment for SUD treatment services after those services have already been rendered. This ensures patients are not left unexpectedly responsible for the full cost of their treatment.
Applies to All Insurance Plans: The provisions of this bill would apply to all health insurance plans, including those offered through the state's health insurance marketplace, employer-sponsored plans, and government-sponsored plans like Medicaid.
Establishes Oversight and Enforcement: The bill grants the state's Department of Banking and Insurance the authority to monitor compliance and take enforcement actions against any insurance providers found to be violating the prohibition on retrospective SUD treatment payment denials.
Improved Access to SUD Treatment: By removing the risk of retrospective payment denials, this bill is intended to encourage more individuals to seek necessary SUD treatment without fear of facing unaffordable out-of-pocket costs.
Enhanced Financial Protections for Patients: Patients receiving SUD treatment will have greater certainty that their insurance coverage will be honored, shielding them from potentially devastating medical debt.
Increased Utilization of Evidence-Based SUD Therapies: With the threat of retroactive payment denials eliminated, health care providers may be empowered to prescribe a fuller range of SUD treatment options without concern about insurance coverage challenges.
This bill, A 3767, was introduced in the state legislature on January 30, 2025 and has been referred to the Insurance committee for further consideration. A companion bill, S 2644, has also been introduced in the state Senate.
Compiled from official sources — confirm details with the bill’s official record.
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