SB 5313 - DIGEST

(SUBSTITUTED FOR - SEE 1ST SUB)

     Requires that every health carrier that provides coverage for any outpatient mental health service shall comply with the following requirements:

     (1) In performing a utilization review of mental health services for a specific enrollee, the person performing the utilization review is limited to accessing only the specific health care information for the particular enrollee in question that is necessary to complete the review.

     (2) In performing an audit of mental health services, the person performing the audit is limited to accessing only the records of persons covered by the specific health carrier for which the audit is being performed, except as otherwise permitted by RCW 70.02.050 and 71.05.630.