Introduced Version
HOUSE BILL No. 1381
_____
DIGEST OF INTRODUCED BILL
Citations Affected:
IC 5-10-8-9
;
IC 12-17.6-4-2
;
IC 27-8-5-15.6
;
IC 27-13-7-14.8.
Synopsis: Mental health insurance coverage. Includes services for
substance abuse within the definition of "coverage of services for
mental illness", for purposes of the law prohibiting the application of
treatment limitations or financial requirements to coverage of services
for mental illness if similar limitations or requirements do not apply to
the coverage of services for other medical or surgical conditions. (The
introduced version of this bill was prepared by the Indiana commission
on mental health.)
Effective: July 1, 2001.
Crosby, Goeglein
January 11, 2001, read first time and referred to Committee on Insurance, Corporations and
Small Business.
Introduced
First Regular Session 112th General Assembly (2001)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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HOUSE BILL No. 1381
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Be it enacted by the General Assembly of the State of Indiana:
SOURCE: IC 5-10-8-9; (01)IN1381.1.1. -->
SECTION 1.
IC 5-10-8-9
, AS AMENDED BY P.L.81-1999,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 9. (a) This section does not apply if the
application of this section would increase the premiums of the health
services policy or plan, as certified under
IC 27-8-5-15.7
, by more than
four percent (4%) as a result of complying with subsection (c).
(b) As used in this section, "coverage of services for mental illness"
includes benefits with respect to mental health services as defined by
the contract, policy, or plan for health services.
However, The term
does not include includes services for the treatment of substance abuse
or and chemical dependency.
(c) If the state enters into a contract for health services through
prepaid health care delivery plans, medical self-insurance, or group
health insurance for state employees, the contract may not permit
treatment limitations or financial requirements on the coverage of
services for mental illness if similar limitations or requirements are not
imposed on the coverage of services for other medical or surgical
conditions.
(d) This section applies to a contract for health services through
prepaid health care delivery plans, medical self-insurance, or group
medical coverage for state employees that is issued, entered into, or
renewed after June 30, 1997.
(e) This section does not require the contract for health services to
offer mental health benefits.
SOURCE: IC 12-17.6-4-2; (01)IN1381.1.2. -->
SECTION 2.
IC 12-17.6-4-2
, AS ADDED BY P.L.273-1999,
SECTION 177, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2001]: Sec. 2. (a) The benefit package provided
under the program shall focus on age appropriate preventive, primary,
and acute care services.
(b) The office shall offer health insurance coverage for the following
basic services:
(1) Inpatient and outpatient hospital services.
(2) Physicians' services provided by a physician (as defined in 42
U.S.C. 1395x(r)).
(3) Laboratory and x-ray services.
(4) Well-baby and well-child care, including:
(A) age appropriate immunizations; and
(B) periodic screening, diagnosis, and treatment services
according to a schedule developed by the office.
The office may offer services in addition to those listed in this
subsection if appropriations to the program exist to pay for the
additional services.
(c) The office shall offer health insurance coverage for the following
additional services if the coverage for the services has an actuarial
value equal to or greater than the actuarial value of the services
provided by the benchmark program determined by the children's
health policy board established by
IC 4-23-27-2
:
(1) Prescription drugs.
(2) Mental health services.
(3) Vision services.
(4) Hearing services.
(5) Dental services.
(d) Notwithstanding subsections (b) and (c), the office may not
impose treatment limitations or financial requirements on the coverage
of services for a mental illness, including services for the treatment
of substance abuse and chemical dependency, if similar treatment
limitations or financial requirements are not imposed on coverage for
services for other illnesses.
SOURCE: IC 27-8-5-15.6; (01)IN1381.1.3. -->
SECTION 3.
IC 27-8-5-15.6
, AS AMENDED BY P.L.81-1999,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 15.6. (a) As used in this section, "coverage of
services for a mental illness" includes the services defined under the
policy of accident and sickness insurance (as defined in
IC 27-8-5-1
).
However, The term does not include includes services for the treatment
of substance abuse or and chemical dependency.
(b) This section applies to a policy of accident and sickness
insurance (as defined in
IC 27-8-5-1
) that:
(1) is issued on an individual basis or a group basis;
(2) is issued, entered into, or renewed after December 31, 1999;
and
(3) is issued to an employer that employs more than fifty (50)
full-time employees.
(c) This section does not apply to the following:
(1) An insurance policy listed under
IC 27-8-15-9
(b).
(2) A legal business entity that has obtained an exemption under
IC 27-8-5-15.7.
(d) A group or individual insurance policy or agreement may not
permit treatment limitations or financial requirements on the coverage
of services for a mental illness if similar limitations or requirements are
not imposed on the coverage of services for other medical or surgical
conditions.
(e) This section does not require a group or individual insurance
policy or agreement to offer mental health benefits.
(f) The benefits delivered under this section may be delivered under
a managed care system.
SOURCE: IC 27-13-7-14.8; (01)IN1381.1.4. -->
SECTION 4.
IC 27-13-7-14.8
, AS AMENDED BY P.L.81-1999,
SECTION 5, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2001]: Sec. 14.8. (a) As used in this section, "coverage of
services for a mental illness" includes the services defined under the
contract with the health maintenance organization.
However, The term
does not include includes services for the treatment of substance abuse
or and chemical dependency.
(b) This section applies to a group or individual contract with a
health maintenance organization that:
(1) is issued, entered into, or renewed after December 31, 1999;
and
(2) is issued to an employer that employs more than fifty (50)
full-time employees.
(c) This section does not apply to a legal business entity that has
obtained an exemption under
IC 27-8-5-15.7.
(d) A group or individual contract with a health maintenance
organization may not permit treatment limitations or financial
requirements on the coverage of services for a mental illness if similar
limitations or requirements are not imposed on the coverage of services
for other medical or surgical conditions.
(e) This section does not require a group or individual contract with
a health maintenance organization to offer mental health benefits.