Revision: Jan. 19, 2021, 12:01 p.m.
SB 59 - AS INTRODUCED
2021 SESSION
21-0894
04/05
SENATE BILL 59
AN ACT relative to the collaborative care model service delivery method.
SPONSORS: Sen. Sherman, Dist 24; Sen. Bradley, Dist 3; Sen. Rosenwald, Dist 13; Rep. Marsh, Carr. 8; Rep. Woods, Merr. 23
COMMITTEE: Health and Human Services
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ANALYSIS
This bill requires individual and group insurers to reimburse a primary care physician for the treatment of mental health and substance use disorders provided 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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
21-0894
04/05
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty One
AN ACT relative to the collaborative care model service delivery method.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Accident and Health Insurance; Individual Coverage for Collaborative Care. Amend RSA 415 by inserting after section 6-aa the following new section:
415:6-bb Individual 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) “The Psychiatric Collaborative Care Model” means the evidence-based, integrated behavioral health service delivery method described 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 reimbursement to a primary care physician for such benefits for the treatment of mental health and substance use disorders that are delivered through the psychiatric collaborative care model, which includes the following treatment components:
(a) Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by a primary care physician, with the following required elements:
(1) Outreach to and engagement in treatment of a patient directed by the primary care physician.
(2) Initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan.
(3) Review by the psychiatrist consultant with modifications of the plan if recommended.
(4) Entering the patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatrist consultant.
(5) Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.
(b) Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by the primary care physician, with the following required elements:
(1) Tracking patient follow-up and progress using the registry, with appropriate documentation.
(2) Participation in weekly caseload consultation with the psychiatrist consultant.
(3) Ongoing collaboration with and coordination of the patient’s mental health care with the primary care physician and any other treating mental health providers.
(4) Additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatrist consultant.
(5) Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.
(6) Monitoring of patient outcomes using validated rating scales and relapse prevention planning with patients as they achieve remission of symptoms and other treatment goals and are prepared for discharge from active treatment.
(c) Each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by the primary care physician for either initial or subsequent psychiatric collaborative care management.
2 New Section; Accident and Health Insurance; Group Coverage for Collaborative Care. Amend RSA 415 by inserting after section 18-ee the following new section:
415:18-ff Group 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) “The Psychiatric Collaborative Care Model” means the evidence-based, integrated behavioral health service delivery method described 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 reimbursement to a primary care physician for such benefits for the treatment of mental health and substance use disorders that are delivered through the psychiatric collaborative care model, which includes the following treatment components:
(a) Initial psychiatric collaborative care management, first 70 minutes in the first calendar month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by a primary care physician, with the following required elements:
(1) Outreach to and engagement in treatment of a patient directed by the primary care physician.
(2) Initial assessment of the patient, including administration of validated rating scales, with the development of an individualized treatment plan.
(3) Review by the psychiatrist consultant with modifications of the plan if recommended.
(4) Entering the patient in a registry and tracking patient follow-up and progress using the registry, with appropriate documentation, and participation in weekly caseload consultation with the psychiatrist consultant.
(5) Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.
(b) Subsequent psychiatric collaborative care management, first 60 minutes in a subsequent month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by the primary care physician, with the following required elements:
(1) Tracking patient follow-up and progress using the registry, with appropriate documentation.
(2) Participation in weekly caseload consultation with the psychiatrist consultant.
(3) Ongoing collaboration with and coordination of the patient’s mental health care with the primary care physician and any other treating mental health providers.
(4) Additional review of progress and recommendations for changes in treatment, as indicated, including medications, based on recommendations provided by the psychiatrist consultant.
(5) Provision of brief interventions using evidence-based techniques such as behavioral activation, motivational interviewing, and other focused treatment strategies.
(6) Monitoring of patient outcomes using validated rating scales and relapse prevention planning with patients as they achieve remission of symptoms and other treatment goals and are prepared for discharge from active treatment.
(c) Each additional 30 minutes in a calendar month of behavioral health care manager activities, in consultation with a psychiatrist consultant, and directed by the primary care physician for either initial or subsequent psychiatric collaborative care management.
3 Health Service 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 415:6-z, RSA 415:6-a1, RSA 415:6-bb, 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 415:18-dd, RSA 415:18-ee, RSA 415:18-ff, 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 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 415:6-z, RSA 415:6-a1, RSA 415:6-bb, 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 415:18-dd, RSA 415:18-ee, RSA 415:18-ff, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.