Provider Participation in Health Insurance

If a mental health provider, substance use disorder provider, or psychiatric nurse (provider) has not submitted a claim for a period of at least 12 months, the act requires a commercial insurance carrier (carrier) to contact the provider to confirm the provider's participation in the carrier's provider network and to determine whether the provider is accepting new patients. The act includes mental health providers, substance use disorder providers, and psychiatric nurses as providers who may participate in a carrier's provider network. The act requires carriers to admit prelicensed providers into the carrier's network and to reimburse prelicensed providers for services rendered when provided under the supervision of a mental health provider, substance use disorder provider, or psychiatric nurse.

The act requires a clinical social worker to complete 3,000 hours of practice prior to licensure.(Note: This summary applies to this bill as enacted.)