Revision: Dec. 22, 2021, 10:52 a.m.
HB 1622-FN - AS INTRODUCED
2022 SESSION
22-2725
05/04
HOUSE BILL 1622-FN
AN ACT relative to mental health parity.
SPONSORS: Rep. Luneau, Merr. 10; Rep. Bartlett, Merr. 19; Rep. Knirk, Carr. 3; Rep. Ladd, Graf. 4; Sen. Whitley, Dist 15; Sen. Sherman, Dist 24
COMMITTEE: Commerce and Consumer Affairs
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ANALYSIS
This bill requires the insurance department to investigate whether certain insurance carrier conduct violates the federal Mental Health Parity and Addiction Equity Act. The bill also requires that insurance reimbursement rates for behavioral health services be no less extensive than any other type of health care services provided to treat physical illness.
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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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
22-2725
05/04
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Two
AN ACT relative to mental health parity.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Subdivision; Mental Health Parity and Addiction Equity Enforcement. Amend RSA 400-A by inserting after section 67 the following new subdivision:
Mental Health Parity and Addiction Equity Enforcement
400-A:68 The Phil Spagnuolo Mental Health Parity and Addiction Equity Enforcement Law.
I. It is in the public interest of the citizens and the businesses of the state of New Hampshire, and to honor the memory of Phil Spagnuolo who helped untold citizens struggling with addiction through both courageous advocacy and the provision of recovery housing and sober living, to fully enforce the provisions of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, as amended, hereinafter “Wellstone-Domenici Parity Act,” to ensure behavioral health reimbursement rates shall be no less extensive than provided for any other type of health care for physical illness, and to ensure meaningful access to justice through a full and adequate complaint process for both consumers and providers.
II. The commissioner shall investigate insurance carrier conduct which may violate the provisions Wellstone-Domenici Parity Act. The commissioner shall conduct an initial assessment of all complaints and alleged violations of the Wellstone-Domenici Parity Act, refer assessed complaints to the appropriate authority if the complaints arise under the ERISA plan, fully investigate all complaints under the Wellstone-Domenici Parity Act within the commissioner's jurisdiction, and hold hearings relative to such conduct. The commissioner may order restitution for a person or persons adversely affected by such insurance carrier conduct.
III. The commissioner may request the assistance and services of the department of justice and shall delegate to the department of justice the authority to investigate alleged violations of the Wellstone-Domenici Parity Act if the insurance department is unable to perform this function or lacks jurisdiction. The commissioner shall provide the department of justice information relevant to the number and type of complaints arising under the Wellstone-Domenici Parity Act and the investigation of such complaints, and shall cooperate with any such investigations or legal proceedings arising therefrom. The department of justice may request information from the commissioner regarding complaints, investigations, and referrals arising under the Wellstone-Domenici Parity Act.
IV. The commissioner shall require insurance carriers to submit, and the commissioner shall make public, annual reports specific to insurance carrier compliance with the Wellstone-Domenici Parity Act. Such annual reports shall include, at a minimum, insurance carrier processes for determining provider reimbursement rates, determining reasonable access to care, evaluating benefit array to align with parity requirements, medical necessity criteria used for behavioral health disorders and determining quantitative treatment limitations, as required by the Wellstone-Domenici Parity Act.
V. Behavioral health reimbursement rates shall be no less extensive than provided for any other type of health care for physical illness.
VI. The commissioner shall establish a mental health parity and addiction equity specific complaint process for both consumers and providers of mental health and addiction services.
2 Coverage for Certain Biologically-Based Mental Illnesses. Amend RSA 417-E:1, II to read as follows:
II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same rates, terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.
3 New Hampshire Granite Advantage Health Care Program. Amend RSA 126-AA:2, I(e) to read as follows:
(e) In order to combat the opioid and heroin crisis facing New Hampshire, the department shall establish behavioral health rates sufficient to ensure access to, and provider capacity for, all behavioral health services including, as appropriate, establishing specific substance use disorder services rate cells for inclusion into capitated rates for managed care. Such behavioral health rates shall be no less extensive than provided for any other type of health care for physical illness. Any person or provider claiming to be aggrieved by a violation of this subparagraph may initiate a civil action against the department in superior court for legal or equitable relief.
4 Effective Date. This act shall take effect upon its passage.
22-2725
Redraft 12/16/21
HB 1622-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to mental health parity.
FISCAL IMPACT: [ X ] State [ ] County [ ] Local [ ] None
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| |||
| Estimated Increase / (Decrease) | |||
STATE: | FY 2022 | FY 2023 | FY 2024 | FY 2025 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | $0 | Indeterminable | Indeterminable | Indeterminable |
Expenditures | $0 | Insurance Department: $339,100; DHHS: Indeterminable | Insurance Department: $344,300; DHHS: Indeterminable | Insurance Department: $349,400; DHHS: Indeterminable |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ X ] Other - Matching federal Medicaid funds. | |||
METHODOLOGY:
This bill requires the NH Insurance Department to fully investigate all complaints relative to the federal Mental Health Parity and Addiction Equity Act. In addition, the bill requires that reimbursement rates for behavioral health services, including those provided under the NH Granite Advantage Health Care Program, be no less extensive than those for health services used to treat physical illness.
The Insurance Department states that in order to meet the bill's requirements, it will need to hire three full-time positions, each starting on July 1, 2022. The estimated costs are as follows:
| FY 2023 | FY 2024 | FY 2025 |
Market Conduct Examiner, LG 32 |
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| |
Salary | $ 80,100 | $ 81,300 | $ 82,500 |
Benefits | $ 37,600 | $ 38,200 | $ 38,800 |
Other | $ 3,400 | $ 3,500 | $ 3,500 |
Position Total | $ 121,100 | $ 123,000 | $ 124,800 |
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Hearing Officer, LG 31 |
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Salary | $ 76,500 | $ 77,600 | $ 78,800 |
Benefits | $ 37,300 | $ 37,900 | $ 38,500 |
Other | $ 3,400 | $ 3,500 | $ 3,500 |
Position Total | $ 117,200 | $ 119,000 | $ 120,800 |
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Consumer Services Representative, LG 26 |
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Salary | $ 61,200 | $ 62,100 | $ 63,000 |
Benefits | $ 36,200 | $ 36,700 | $ 37,300 |
Other | $ 3,400 | $ 3,500 | $ 3,500 |
Position Total | $ 100,800 | $ 102,300 | $ 103,800 |
Grand Total | $ 339,100 | $ 344,300 | $ 349,400 |
The Department states that the bill's impact on insurance premium tax revenue, if any, is indeterminable.
In addition to the above, the bill creates a cause of action to those who claim to be aggrieved by a violation of the provision requiring parity of rates under the NH Granite Advantage Health Care Program. The Department of Health and Human Services states that it already includes parity compliance, analysis, and reporting provisions in its contracts with Medicaid managed care organizations. Despite this, to the extent that the bill results in the Department being court-ordered to increase rates or award monetary damages, the bill may result in an indeterminable increase in state and federal Medicaid expenditures.
AGENCIES CONTACTED:
Department of Health and Human Services and Insurance Department