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 415:18, 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 415:22, 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 415:18, 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 415:22, 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 415:18, 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-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 415:18, 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-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.

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.