THE SENATE

S.B. NO.

339

THIRTY-SECOND LEGISLATURE, 2023

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

relating to health insurance.

 

 

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

 


SECTION 1. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A, part I, to be appropriately designated and to read as follows:

"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 this State after December 31, 2023, 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 Addition 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, 2023, 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 Addition 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 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 benefit to be provided by health maintenance organizations corresponding to the benefit provided under sections 431:10A-  , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 3 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2023.

SECTION 5. 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 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect on July 1, 2023; 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, 2023; provided further that section 5 shall take effect upon approval of the Hawaii medicaid state plan by the Centers for Medicare and Medicaid Services.

 

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.