IN HB 1201: Various mental health and insurance matters.

Indiana HB 1201 addresses several mental health and insurance regulatory matters. The bill prohibits the use of an artificial intelligence system to impersonate or act as a substitute for a licensed mental health professional. It also requires the Indiana Department of Insurance to contract with an objective third party to verify that health carriers are in compliance with network adequacy standards.

The bill sets forth notice requirements for amendments to health provider contracts and prohibits the use of downcoding in a specified manner. It requires insurers and health maintenance organizations to reimburse providers of mental illness or substance abuse services at rates that are at least as favorable relative to Medicare rates as reimbursement rates are for providers of medical or surgical services relative to Medicare rates. This parity-style reimbursement requirement directly parallels the rate-equivalence logic underlying federal mental health parity frameworks.

HB 1201 also prohibits insurers and health maintenance organizations from retroactively auditing a paid claim or seeking recoupment or a refund of a paid claim after a certain time frame. Additionally, the bill sets forth a limitation on the amount that an insured or enrollee may be charged for receiving mental and behavioral care services from an out-of-network provider under certain circumstances. The bill's latest action reflects ongoing legislative activity, with Representative Goss-Reaves added as coauthor.