SB739 (2020) Detail

Relative to mental health and substance use disorder insurance coverage.


SB 739-FN - AS INTRODUCED

 

 

2020 SESSION

20-2886

01/10

 

SENATE BILL 739-FN

 

AN ACT relative to mental health and substance use disorder insurance coverage.

 

SPONSORS: Sen. Sherman, Dist 24; Sen. Watters, Dist 4; Sen. Morgan, Dist 23; Sen. Hennessey, Dist 5; Sen. Bradley, Dist 3; Rep. Indruk, Hills. 34; Rep. Marsh, Carr. 8; Rep. Fothergill, Coos 1

 

COMMITTEE: Commerce

 

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ANALYSIS

 

This bill requires insurers providing benefits for mental health and substance use disorders to reimburse covered persons for benefits delivered through the psychiatric collaborative care model.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

20-2886

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty

 

AN ACT relative to mental health and substance use disorder insurance coverage.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  New Section; Accident and Health Insurance; Coverage for Collaborative Care; Individual.  Amend RSA 415 by inserting after section 6-x the following new section:

415:6-y  Coverage for Collaborative Care.

I.  In this section:

(a)  “Mental health and substance use disorder benefits” means benefits for the treatment of any condition or disorder that involves a mental health condition or substance use disorder that falls under any of the diagnostic categories listed in the mental disorders section of the current edition of the International Classification of Disease or that is listed in the mental disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental Disorders.

(b)  “Other behavioral health integration” means an integrated behavioral health service delivery method other than the psychiatric collaborative care model, as such service delivery methods are described in rules of the Centers for Medicare and Medicaid services at 81 Federal Register 46205.

(c)  “The psychiatric collaborative care model” means the evidence-based, integrated behavioral health service delivery method described in rules of the Centers for Medicare and Medicaid services at 81 Federal Register 80230.

II.  Each insurer that issues or renews any individual policy of accident or health insurance providing benefits for medical or hospital expenses, that provides coverage for mental health and substance use disorders shall provide to certificate holders of such insurance, who are residents of this state, reimbursement for such benefits that are delivered through the psychiatric collaborative care model or other behavioral health integration service delivery methods, which shall include the following current procedural terminology (CPT) billing codes established by the American Medical Association (AMA):  

(a)  99492.

(b)  99493.

(c)  99494.

(d)  99484.

(e)  The commissioner shall update this list of codes if there are any alterations or additions to the billing codes for the collaborative care model or other behavioral health integration services.

III.  An insurer may deny reimbursement of any CPT code listed in paragraph II on the grounds of medical necessity, provided that such medical necessity determinations are in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, including any amendments thereto and any federal rules adopted thereunder and that such determinations are made in accordance with the utilization review requirements found in RSA 420-E.

2  New Section; Accident and Health Insurance; Coverage for Collaborative Care; Group.  Amend RSA 415 by inserting after section 18-bb the following new section:

415:18-cc  Coverage for Collaborative Care.

I.  In this section:

(a)  “Mental health and substance use disorder benefits” means benefits for the treatment of any condition or disorder that involves a mental health condition or substance use disorder that falls under any of the diagnostic categories listed in the mental disorders section of the current edition of the International Classification of Disease or that is listed in the mental disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental Disorders.

(b)  “Other behavioral health integration” means an integrated behavioral health service delivery method other than the psychiatric collaborative care model, as such service delivery methods are described in rules of the Centers for Medicare and Medicaid services at 81 Federal Register 46205.

(c)  “The psychiatric collaborative care model” means the evidence-based, integrated behavioral health service delivery method described in rules of the Centers for Medicare and Medicaid services at 81 Federal Register 80230.

II.  Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses, that provides coverage for mental health and substance use disorders shall provide to certificate holders of such insurance, who are residents of this state, reimbursement for such benefits that are delivered through the psychiatric collaborative care model or other behavioral health integration service delivery methods, which shall include the following current procedural terminology (CPT) billing codes established by the American Medical Association (AMA):  

(a)  99492.

(b)  99493.

(c)  99494.

(d)  99484.

(e)  The commissioner shall update this list of codes if there are any alterations or additions to the billing codes for the collaborative care model or other behavioral health integration services.

III.  An insurer may deny reimbursement of any CPT code listed in paragraph II on the grounds of medical necessity, provided that such medical necessity determinations are in compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, including any amendments thereto and any federal rules adopted thereunder and that such determinations are made in accordance with the utilization review requirements found in RSA 420-E.

3  Health Services Corporations; Applicable Statutes.  Amend RSA 420-A:2 to read as follows:

420-A:2  Applicable Statutes.  Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included.  Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.  

4  Health Services Corporations; Applicable Statutes; Effective January 2021.  Amend RSA 420-A:2 to read as follows:

420-A:2  Applicable Statutes.  Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included.  Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

5  Health Maintenance Organizations; Statutory Construction.  Amend RSA 420-B:20, III to read as follows:

III.  The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

6  Health Maintenance Organizations; Statutory Construction; Effective January 1, 2021.  Amend RSA 420-B:20, III to read as follows:

III.  The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:6-w, RSA 415:6-x, RSA 415:6-y, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:18-bb, RSA 415:18-cc, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.  

7  Effective Date.

I.  Sections 4 and 6 shall take effect January 1, 2021 at 12:03 p.m.

II.  The remainder of this act shall take effect 60 days after its passage.

 

LBAO

20-2886

1/7/20

 

SB 739-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to mental health and substance use disorder insurance coverage.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2020

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

$0

Indeterminable

Indeterminable

Indeterminable

   Expenditures

$0

$0

$0

$0

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [    ] Other

 

METHODOLOGY:

This bill requires insurers providing benefits for mental health and substance use disorders to reimburse covered individuals for benefits provided via the collaborative care model.  The Insurance Department states that to the extent this type of care was not covered before, and depending on how the cost and efficacy of this care compares to currently covered services, the bill may impact claims, premiums, and plan designs.  This may in turn have an indeterminable impact on insurance premium tax revenue.

 

The Department of Health and Human Services states the bill will have no fiscal impact on that department.

 

AGENCIES CONTACTED:

Insurance Department and Department of Health and Human Services

 

Links

SB739 at GenCourtMobile
SB739 Discussion

Action Dates

Date Body Type
Jan. 28, 2020 Senate Hearing
March 12, 2020 Senate Floor Vote
March 11, 2020 Senate Floor Vote
March 11, 2020 Senate Floor Vote

Bill Text Revisions

SB739 Revision: 8065 Date: Jan. 21, 2020, 9:35 a.m.

Docket

Date Status
Jan. 8, 2020 Introduced 01/08/2020 and Referred to Commerce; SJ 2
Jan. 28, 2020 Hearing: 01/28/2020, Room 100, SH, 02:15 pm; SC 4
March 11, 2020 Committee Report: Ought to Pass, 03/11/2020; Vote 5-0; CC; SC 10
March 12, 2020 Committee Report: Ought to Pass, 03/12/2020; Vote 5-0; CC; SC 10
March 11, 2020 Sen. Morse Moved to Remove SB 739 from the Consent Calendar; 03/11/2020; SJ 6
March 12, 2020 Special Order to 03/12/2020, Without Objection, MA; 03/11/2020 SJ 6
March 12, 2020 Ought to Pass: RC 24Y-0N, MA; OT3rdg; 03/12/2020; SJ 7
June 30, 2020 Introduced and Laid on Table MA VV 06/30/2020