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THE SENATE |
S.B. NO. |
2468 |
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THIRTY-SECOND LEGISLATURE, 2024 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to health insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
"§431:10A- Annual mental health wellness examination coverage. (a) Each individual and group policy of accident and health or sickness insurance issued or renewed in the State after December 31, 2024, except for policies that only provide coverage for a specified disease or other limited benefit coverage as described in section 431:10A-607, shall provide coverage for an annual mental health wellness examination.
(b)
The coverage required by this section shall include an annual mental
health wellness examination of up to sixty minutes that is performed by a
qualified mental health care provider.
The coverage for an annual mental health wellness examination shall not
be less extensive than the coverage provided for a physical examination and
shall comply with all requirements of the federal Mental Health Parity and Addiction
Equity Act.
(c) The mental health wellness
examination required by this section shall be exempt from any deductible or
copayment provisions that may be in force in any policy or contract. Each accident and health or sickness insurer
shall reimburse all costs associated with the coverage required by this section
to any qualified mental health care provider complying with this section.
(d) For purposes of this section:
"Mental health wellness examination" means an examination that
seeks to identify any behavioral or mental health needs and appropriate
resources for treatment. The examination
may include:
(1) Observation;
(2) A behavioral health screening;
(3) Education and consultation on healthy
lifestyle changes;
(4) Referrals for ongoing treatment,
mental health services, and other necessary supports;
(5) Discussion of potential options for
medication; and
(6) Age-appropriate screenings or observations to understand a covered person's mental health history, personal history, and mental or cognitive state and, when appropriate, relevant adult input through screenings, interviews, and questions.
"Qualified
mental health care provider" means:
(1) A physician licensed pursuant to
chapter 453 who is board certified in psychiatry or other mental health or
behavioral health care areas;
(2) A physician assistant licensed
pursuant to chapter 453 who has training in psychiatry or mental health;
(3) A psychologist licensed pursuant to
chapter 465;
(4) A clinical social worker licensed
pursuant to chapter 467E;
(5) A marriage and family therapist
licensed pursuant to chapter 451J;
(6) A mental health counselor licensed
pursuant to chapter 453D;
(7) A substance abuse counselor
certified pursuant to section 321-193(10); or
(8) An advanced practice registered nurse licensed pursuant to chapter 457 who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article I to be appropriately designated and to read as follows:
"§432:1- Annual mental health wellness examination coverage. (a) Each individual or group hospital or medical service plan contract issued or renewed in this State after December 31, 2024, shall provide coverage for an annual mental health wellness examination.
(b)
The coverage required by this section shall include an annual mental
health wellness examination of up to sixty minutes that is performed by a
qualified mental health care provider.
The coverage for an annual mental health wellness examination shall not
be less extensive than the coverage provided for a physical examination and
shall comply with all requirements of the federal Mental Health Parity and Addiction
Equity Act.
(c) The mental health wellness
examination required by this section shall be exempt from any deductible or
copayment provisions that may be in force in any contract. Each mutual benefit society shall reimburse
all costs associated with the coverage required by this section to any
qualified mental health care provider complying with this section.
(d) For purposes of this section:
"Mental health wellness examination" means an examination that
seeks to identify any behavioral or mental health needs and appropriate
resources for treatment. The examination
may include:
(1) Observation;
(2) A behavioral health screening;
(3) Education and consultation on healthy
lifestyle changes;
(4) Referrals for ongoing treatment,
mental health services, and other necessary supports;
(5) Discussion of potential options for
medication; and
(6) Age-appropriate screenings or observations to understand a covered person's mental health history, personal history, and mental or cognitive state and, when appropriate, relevant adult input through screenings, interviews, and questions.
"Qualified
mental health care provider" means:
(1) A physician licensed pursuant to
chapter 453 who is board certified in psychiatry or other mental health or
behavioral health care areas;
(2) A physician assistant licensed
pursuant to chapter 453 who has training in psychiatry or mental health;
(3) A psychologist licensed pursuant to
chapter 465;
(4) A clinical social worker licensed
pursuant to chapter 467E;
(5) A marriage and family therapist
licensed pursuant to chapter 451J;
(6) A mental health counselor licensed
pursuant to chapter 453D;
(7) A substance abuse counselor
certified pursuant to section 321-193(10); or
(8) An advanced practice registered nurse licensed pursuant to chapter 457 who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization."
SECTION 3. Section 432D:23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23 Required provisions and
benefits. Notwithstanding any other provision
of law to the contrary, each policy, contract, plan, or agreement issued in the
State after January 1, 1995, by health maintenance organizations pursuant to
this chapter, shall include benefits provided in sections 431:10-212,
431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2, 431:10A-116.5, 431:10A-116.6,
431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126,
431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, [and 431:10A-134,]
431:10A- , and chapter 431M."
SECTION 4. The coverage required under sections 1, 2, and 3 of this Act shall apply to all plans under medicaid managed care programs in the State.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on July 1, 2024; provided that sections 1, 2, and 3 shall apply to all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2024; provided further that section 4 shall take effect upon approval of the Hawaii medicaid state plan by
the Centers for Medicare and Medicaid Services.
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INTRODUCED BY: |
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Report Title:
Health Insurance; Mandated Coverage; Annual Mental Health Wellness Examination
Description:
Requires all health insurers in the state, including medicaid managed care programs, to cover annual mental health wellness examinations.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.