| SB 0622 | Revises current law regarding insurance coverage for mental health conditions and chemical dependency |
| Sponsor: | Loudon | |||
| LR Number: | 1911S.01I | Fiscal Note: | 1911-01 | |
| Committee: | Small Business, Insurance & Industrial Relations | |||
| Last Action: | 03/03/03 - Second Read and Referred S Small Business, Insurance | Journal page: | S359 | |
| and Industrial Relations Committee | ||||
| Title: | ||||
| Effective Date: | August 28, 2003 | |||
SB 622 - This act revises the current law with respect to health insurance coverage for mental health conditions and chemical dependencies.
CHEMICAL DEPENDENCY COVERAGE - Under this act, coverage offered under a group health insurance policy for outpatient treatment through a nonresidential treatment program shall not exceed 26 days per policy benefit period. Under the current law, 26 days is the minimum number of days. Under this act, the lifetime frequency cap on chemical dependency coverage is limited to 5 episodes of treatment (current law requires a minimum of 10 episodes of treatment). The provision of law which allows insurers to limit inpatient hospital treatment for mental illness to 90 days per year is repealed (Section 376.811.2, RSMo). The act provides that these chemical dependency provisions only apply to group policies and not individual accident and sickness insurance policies.
MENTAL HEALTH CONDITION - This act requires health carriers that offer health benefit plans in this state on or after January 1, 2004, shall provide covered services for mental health conditions. Mental health conditions are defined as those listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders IV. Coverage for mental health conditions cannot have rates, terms, or conditions that place a greater financial burden on an insured for mental health treatment than for a physical health condition. Any deductible or out-of-pocket limits required by a health carrier shall be comprehensive for coverage for all health conditions, whether mental or physical. Coverage and treatment of mental health conditions may be provided through a managed care organization. The act does not apply to supplemental insurance policies.
The act also repeals several sections relating to mental illness and addictive disorders. The sections repealed include current exceptions to the requirement that health insurers who cover services for mental illness and addictive disorders provide the same coverage as they do for physical illness. These sections (Sections 376.825 - 376.840) are collectively known as the "Mental Health and Chemical Dependency Insurance Act".
This act is substantially similar to the perfected version
of HB 1440 (2002).
STEPHEN WITTE