Prior authorization or referral requirement for in

network mental health or substance use disorder services coverage prohibited. A. A health insurer shall not require prior authorization and referral requirements for the following mental health or substance use disorder services: (1) acute or immediately necessary care; (2) acute episodes of chronic mental health or substance use disorder conditions; or (3) initial in-network inpatient or outpatient substance use treatment services. B. Prior authorization shall be determined in consultation with the insured's mental health or substance use disorder services provider for: (1) continuation of services in chronic or stable conditions; or (2) additional services. C. Except in cases in which the insured terminates a plan, a health insurer shall not terminate coverage of services without consultation with the insured's mental health or substance use disorder services provider. D. A health insurer shall not limit coverage for mental health or substance use disorder services up to the point of relief of presenting signs and symptoms or to short- term care or acute treatment. E. The duration of coverage for an insured with a mental health or substance use disorder shall be based on the mental health or substance use disorder needs of the insured rather than on arbitrary time limits. F. A health insurer may require a mental health or substance use disorder services provider to provide notification to the health insurer after the initiation of in-network mental health or substance use disorder treatment pursuant to Subsection A of this section. G. If a provider fails to notify a health insurer pursuant to Subsection F of this section, a health insurer may perform appropriate utilization review. H. A health insurer may require a mental health or substance use disorder services provider to develop and submit a treatment plan for an insured receiving in-network services in a manner that is compliant with federal law. History: Laws 2023, ch. 114, § 12.