Mandates
~$2.47 billion in premium costs

• hearing aids

• licensed marriage and family therapists
• oral cancer therapy

• 14 days coverage of inpatient SUD services without medical management

• lyme disease

• HIV associated lipodystrophy syndrome treatment mandate)

• Out of Network,

• PANDA/PANS telehealth

• abortion mandate, elimination of cost-sharing for abortion and abortion related care

• Mental health wellness exam

• Coverage for disabled dependents mandate)

• (PreP Coverage Mandate)

Assessments
~$3.1 billion in assessments on payers from 2013 – 2023
Assessment on surcharge payers to fund HPC and CHIA
Assessment on surcharge payers to fund Vaccine Purchase Trust Fund
MCPAP assessment

Behavioral Health Trust Fund and Behavioral Health Advisory Commission)
BH Assessment on Payers

Limits on Health Plan Tools

• Mandates 14 days coverage of CSS without medical management

• Limits health plans and pharmacy benefit managers’ ability to audit pharmacies

• Behavioral Health – elimination of PA for acute inpatient, CBAT, ICBAT, changes to OPP regulations re: MN decisions)

• Limitations on Retroactive denials

• Limitations on step therapy