Report Title:

Previously Undiagnosed Medical and Psychological Conditions

Description:

Establishes health insurance provisions for initial medical visits and psychological assessments, including previously undiagnosed medical and psychological conditions.

HOUSE OF REPRESENTATIVES

H.B. NO.

1483

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

Relating to previously undiagnosed conditions.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that health insurers often refuse payment for initial medical visits and psychological assessments when such medical visits and psychological assessments include previously undiagnosed medical and psychological conditions. The purpose of this Act is to mandate that insurers provide reimbursement to health providers for initial medical visits and psychological assessments, even when such medical visits and psychological assessments may include previously undiagnosed medical and psychological conditions.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A-   Previously undiagnosed medical and psychological conditions; notice. (a) Any other law to the contrary notwithstanding, each employer group health policy, contract, plan, or agreement issued or renewed in this State after December 31, 2005, shall provide, not as an employer option, reimbursement to health providers for initial medical visits and psychological assessments, even when such medical visits and psychological assessments may include previously undiagnosed medical and psychological conditions.

(b) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2005 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2005."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432-   Previously undiagnosed medical and psychological conditions; notice. (a) Any other law to the contrary notwithstanding, each individual and group hospital or medical service plan, policy, contract, or agreement issued or renewed in this State after December 31, 2005, shall provide, not as an employer option, reimbursement to health providers for initial medical visits and psychological assessments, even when such medical visits and psychological assessments may include previously undiagnosed medical and psychological conditions, for the member and individuals covered under the service plan, policy, contract, or agreement.

(b) Every mutual benefit society shall provide notice to its members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2005 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2005."

SECTION 4. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:

"§432D-23 Required provisions and benefits. Notwithstanding any 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-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, [and] 431:10A-121, and 431:10A-   , and chapter 431M."

SECTION 5. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under section 431:10A-   , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2005.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.

INTRODUCED BY:

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