Excerpt: There is a new requirement for the plan administrator to disclose the criteria for medical necessity determinations made under the plan with respect to mental health or substance use disorder benefits to any current or potential plan participant, beneficiary or contracting provider upon request. The rule also requires that the reasons for any claim denials of payment for services or reimbursement with respect to mental health or substance use disorder benefits be made available to the plan participant or beneficiary on request or as otherwise required by regulations.  MORE >>