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1998 SESSION

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SB 430 Health insurance; mental health coverage.

Introduced by: R. Edward Houck | all patrons    ...    notes | add to my profiles

SUMMARY:

Accident and sickness insurance; mental health coverage. Requires health insurers, health services plans and health maintenance organizations to provide benefits for inpatient, partial hospitalization, medication management and outpatient treatment of mental disorders that are as favorable as the benefits for any other illness, condition, or disorder that is covered by the policy or contract. "Mental disorders" are all medically recognized mental illnesses, as defined by the Diagnostic and Statistical Manual, Fourth Edition, as updated from time to time. In addition to requiring parity in benefits, the bill also requires that coverage for mental disorders be no different from coverage for other illnesses or conditions for the purpose of determining deductibles, benefit year or lifetime durational limits, lifetime episodes or treatment limits, copayment and coinsurance factors, and benefit year maximums for deductibles and copayment and coinsurance factors. The bill does not prevent the undertaking of usual and customary procedures to determine the appropriateness and medical necessity for the treatment of mental disorders, so long as such procedures are made in the same manner as the determinations made for the treatment of any other illness or condition.


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