Revision: Jan. 29, 2021, 11:38 a.m.
Health and Human Services
January 29, 2021
2021-0165s
04/11
Amendment to SB 59
Amend the bill by replacing sections 1 and 2 with the following:
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 which includes a formal collaborative arrangement among a primary care team consisting of a primary care provider, a care manager, and a psychiatric consultant, and includes, but is not limited to, the following elements:
(1) Care directed by the primary care team.
(2) Structured care management.
(3) Regular assessments of clinical status using validated tools.
(4) Modification of treatment as appropriate.
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 the treatment of mental health and substance use disorders that are delivered through the psychiatric collaborative care model.
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 which includes a formal collaborative arrangement among a primary care team consisting of a primary care provider, a care manager, and a psychiatric consultant, and includes, but is not limited to, the following elements:
(1) Care directed by the primary care team.
(2) Structured care management.
(3) Regular assessments of clinical status using validated tools.
(4) Modification of treatment as appropriate.
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 the treatment of mental health and substance use disorders that are delivered through the psychiatric collaborative care model.