Bill
HB 40
Requires health insurers to cover medically necessary mental health and substance use treatment, with parity to medical benefits and improved access for enrollees.
Note: the materials you provided include multiple unrelated “HB 40” bills from different states and sessions (fishing licenses, criminal justice council, prostate‑cancer screening, etc.). There is no full text in the packet for the specific HB 40 you identified by title — “Health insurance; require coverage of medically necessary treatment of mental health and substance use disorders.” Because the bill text is not included, the summary below (1) records the concrete metadata you supplied and (2) provides a clear, cautious summary of the bill’s purpose and the typical provisions and impacts such a bill would contain. If you can provide the bill text or identify the state/jurisdiction, I will convert this into a precise, clause‑by‑clause summary.
HB 40 — Health insurance; require coverage of medically necessary treatment of mental health and substance use disorders
Status: Died in Committee
Introduced: August 15, 2025
Subject: Insurance
Summary — what is known
- Primary purpose: To require health insurance plans to cover “medically necessary” treatment for mental health conditions and substance use disorders.
- Procedural status: Introduced 8/15/2025 and reported as “Died In Committee” (did not advance out of committee).
- Topic area: Insurance coverage parity and access to behavioral health treatment.
Key provisions likely reflected by the title (areas to confirm in the bill text)
- Coverage requirement: Insurers (individual, small group, large group, and potentially Medicaid/CHIP plans) would be required to cover medically necessary services for mental health and substance use disorders.
- Definition(s): The bill would typically define “medically necessary” (e.g., services consistent with accepted standards of care) and may list covered services (outpatient therapy, inpatient/residential treatment, medication‑assisted treatment, detoxification, counseling, peer support, case management).
- Parity and limits: The bill would likely require parity with medical/surgical benefits — prohibiting more restrictive financial requirements (copays, deductibles) or treatment limitations (visit limits, day limits) for behavioral health than for comparable physical health benefits.
- Prior authorization and utilization management: Possible limits on prior authorization, step therapy, or other utilization management practices for behavioral health services, or requirements to publish criteria and allow expedited review.
- Network adequacy and access: Requirements that insurers maintain adequate behavioral‑health provider networks and timely access to care (e.g., wait‑time standards).
- Appeals and enforcement: Member appeal rights, external review procedures, and enforcement mechanisms (regulatory oversight, fines, reporting).
- Cost‑sharing: The bill title suggests requiring coverage; some versions also prohibit cost‑sharing for mandated services — this would need to be confirmed in the text.
- Effective date and applicability: The bill would specify effective date and whether it applies to new policies only or renewals as well.
Who would be affected
- Primary: Insurers and managed care plans operating in the jurisdiction and their enrollees (individuals and families) who need behavioral‑health or substance use treatment.
- Secondary: Behavioral‑health providers (increased demand), state insurance regulators (enforcement and monitoring), employers who sponsor health plans (if self‑insured carve‑outs are not preempted).
Potential fiscal and operational impacts (typical)
- Insurer costs: Coverage expansions and parity enforcement can increase insurer expenditures depending on the extent of newly covered services and utilization changes.
- State oversight costs: Insurance departments may incur administrative costs to implement, monitor, and enforce new requirements.
- Health system effects: Increased access could shift care from emergency settings to outpatient treatment, potentially reducing other public costs (criminal justice, acute care), but these downstream savings are uncertain.
Next steps I can take
- If you provide the bill’s jurisdiction (state) or the bill text/pdf, I will produce a point‑by‑point summary of actual statutory changes, list exact definitions, cite key sections, and analyze direct fiscal and regulatory impacts.
Compiled from official sources — confirm details with the bill’s official record.
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