Insurance: health insurers; coverage for intermediate and outpatient care for substance use disorder; modify. Amends secs. 2212e & 3425 of 1956 PA 218 (MCL 500.2212e & 500.3425).

SB 1126 requires Michigan health insurers to use a standardized electronic system for prior authorization requests starting June 1, 2023, to streamline the approval process for medical services. The bill mandates that clinical review criteria used to approve or deny care must be evidence-based, developed by qualified medical entities, and updated at least annually. Additionally, it ensures that adverse decisions on non-drug benefits are made by licensed physicians and that any new coverage restrictions are posted on insurer websites and notified to providers with sufficient lead time. These provisions apply to all health benefit plans issued in the state and aim to increase transparency and consistency in how medical care approvals are handled.