Purpose of the Bill

The purpose of this bill is to adjust the payment rates for outpatient behavioral health services by requiring health insurance providers to reimburse healthcare providers at a rate that is at least 143% of the standard Medicare rate. This aims to improve compensation for providers of important mental health and substance use disorder treatments.

Main Provisions

• The bill mandates that health plan companies pay healthcare providers at least 143% of the Medicare rate for outpatient behavioral health services.
• This applies to various treatments categorized under outpatient behavioral health services, such as outpatient substance use disorder and mental health treatment.
• The regulation does not apply to healthcare coverage provided under state public health care programs, specified in Minnesota Statutes chapter 256B or 256L.

Significant Changes to Existing Law

This bill introduces a new statutory requirement in Minnesota law (Minnesota Statutes chapter 62Q) designed to ensure higher reimbursement rates for outpatient behavioral health services. It aims to ensure providers are adequately compensated above the Medicare benchmark, thereby supporting the sustainability and availability of these essential services.

Relevant Terms

• Behavioral health services
• Medicare rate
• Outpatient treatment
• Substance use disorder
• Mental health treatment
• Health plan companies