Washington Administrative Code › Title 284 - Insurance Commissioner, Office of the › Chapter 284-170 - Health benefit plan management › Subchapter B - HEALTH CARE NETWORKS › Section 284-170-285 - Mental health and substance use disorder web page model format and required content

Current through Register Vol. 24-14, July 15, 2024
(1) Not later than
				July 1, 2021, carriers must establish and maintain a web page entitled
				"Important Mental Health and Substance Use Disorder Treatment Information" that
				complies with the requirements in this section. By July 1, 2021, carriers must
				prominently post the information in subsections (4), (5), (6), (7), and (8) of
				this section on their website so that a member may easily locate it. By March
				1, 2023, carriers must conspicuously post the information in subsection (4) of
				this section related to coverage of behavioral health emergency services on
				their website so that a member can easily locate it.
(2) A member must be able to link to the web
				page from their portal landing page if the carrier provides members with a
				portal. If the carrier does not provide members with a personal electronic
				portal, the carrier must place a link to the web page that is visually
				prominent and easily located on the health plan's network information
				page.
(3) A carrier's transparency
				tool(s) must include the information required in this section to the extent
				that it is required by
				RCW
				 48.43.007(2).
(4) The web page must contain a section that
				explains what to do if an enrollee or their dependent is experiencing a mental
				health or substance use disorder emergency or crisis. This section must
				specifically include, but is not limited to, links and information for the
				National Suicide Prevention hotline, a statement that the health plan will
				cover, without any prior authorization requirement, emergency behavioral health
				services provided by an emergency behavioral health services provider, as
				defined in
				RCW
				 48.43.005, whether the provider is a
				participating or nonparticipating provider, and identify additional resources
				for emergency or crisis intervention within an enrol-lee's service area and
				within Washington state that provide support and services for mental health or
				substance use disorder emergencies or crises. The content for this portion of
				the web page must emphasize the ways an enrollee or their personal
				representative can receive emergency or crisis services covered by their health
				plan, from public health resources, or other private health resources in
				nontechnical and consumer friendly language. This section must be above the
				fold and visually prominent on the mental health and substance use disorder web
				page.
(5) The web page must contain
				accurate information explaining the following information, based on the health
				plan network's access and adequacy standards for mental health and substance
				use disorder treatment and services:
(a) How
				an enrollee can find in-network mental health and substance use disorder
				treatment and services in their service area;
(b) What an enrollee may do if covered
				services are not available in their service area or the enrollee cannot obtain
				access to scheduling an appointment from an in-network provider within 10
				business days for mental health and substance use disorder services covered as
				primary care and 15 business days for those covered as specialty care;
				and
(c) A description of access to
				services based on the applicable time frames, such as the following: "If the
				enrollee seeks covered mental health and substance use disorder treatment
				services for which the enrollee needs a referral or is covered as specialty
				care, an appointment must be made available to the enrollee within 15 days of
				requesting one. If the requested service does not require a referral or is not
				specialty care, the appointment must be made available within 10 business days
				of making a request for an appointment. If an enrollee is unable to schedule an
				appointment within the applicable number of business days, the carrier must
				assist with scheduling an appointment."