Bill Text: HI SB889 | 2019 | Regular Session | Introduced

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Bill Title: Relating To Health.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced - Dead) 2019-01-30 - Re-Referred to CPH, JDC. [SB889 Detail]

Download: Hawaii-2019-SB889-Introduced.html

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THE SENATE	S.B. NO.	889
THIRTIETH LEGISLATURE, 2019
STATE OF HAWAII

A BILL FOR AN ACT

 

 

relating to health.

 

 

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

 

PART I

     SECTION 1.  The legislature finds that according to a 2009 poll conducted for the Closing the Addiction Treatment Gap Initiative, most Americans, regardless of race, age, place of residence, or income, know someone personally who has been addicted to alcohol or drugs.  Additionally, the 2009 poll showed that seventy-three per cent of Americans support the idea of including alcohol and drug addiction treatment as part of national health care reform to make the treatment more accessible and affordable.  Despite widespread concern and support across America, the legislature finds that treatment for behavioral health disorders continues to be costlier and more difficult to obtain than general medical care.  Different financial limits and cost-sharing requirements, limits on coverage, providers, types, and duration of treatment, and other provisions constrain the level and quality of insured health care that is available to those with behavioral health issues.

     Pursuant to the United States Department of the Treasury's interim final rules pertaining to the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, group health plans are required to have no more restrictions on mental health and substance abuse disorders than on medical or surgical benefits.  The legislature finds that while the final rules require action by the State to ensure compliance, the State also has the option to enact and implement parity laws that are even more comprehensive than what is required for federal compliance.

     The purpose of this Act is to convene a mental health and substance abuse parity working group to determine how the State can come into compliance with federal mental health and substance abuse parity laws and regulations and enhance its existing parity laws.

     SECTION 2.  (a)  The director of health shall convene a mental health and substance abuse parity working group and may work with any other department to carry out the purpose of this Act.  The working group shall consist of fifteen members as follows:

     (1)  One member selected by the governor;

     (2)  One member selected by the president of the senate;

     (3)  One member selected by the speaker of the house of representatives;

     (4)  One member selected by the attorney general;

     (5)  One member selected by the insurance commissioner;

     (6)  One member selected by the alcohol and drug abuse division of the department of health;

     (7)  One psychiatrist selected by the adult mental health division of the department of health;

     (8)  One representative of the Coalition for a Drug-Free Hawaii;

     (9)  One representative of the Mental Health America of Hawaii;

    (10)  One representative of the Legal Aid Society of Hawaii;

    (11)  One representative of a health insurance provider, regulated under chapter 431, article 10A; chapter 432, article I; or chapter 432D, Hawaii Revised Statutes, or a managed care provider, such as a health maintenance organization or preferred provider organization;

    (12)  One medical professional licensed under chapter 453, Hawaii Revised Statutes;

    (13)  One psychologist licensed under chapter 465, Hawaii Revised Statutes;

    (14)  One clinical social worker licensed under chapter 467E, Hawaii Revised Statutes; and

    (15)  One mental health consumer representative.

The members referenced in paragraphs (8) to (15) shall be selected by the director of health.

     (b)  The duties of the working group shall be as follows:

     (1)  Review special reports, and updates to the special reports, that provide an analysis of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and relevant final rules;

     (2)  Review the provisions in national health care reform laws and regulations that affect behavioral health care, including:

          (A)  Provisions that interact with the Mental Health Parity and Addiction Equity Act of 2008; and

          (B)  Provisions that address the issue of affordability and lack of coordination of behavioral health care through the establishment of federally qualified behavioral health centers and co-location of primary and specialty care services with behavioral health services;

          provided that any recommendation made pursuant to this paragraph to improve the behavioral health care system shall emphasize primary and secondary prevention and de-stigmatization;

     (3)  Determine the State's role and responsibilities in implementing the Mental Health Parity and Addiction Equity Act of 2008; and

     (4)  Based on information reviewed or determined pursuant to paragraphs (1) through (3), examine and make recommendations regarding the addition or enhancement of various components of the State's mental health and substance abuse parity laws, including:

          (A)  Coverage options, including mandatory coverage of mental illnesses and substance abuse;

          (B)  Definitions of covered conditions and other terms necessary to implement the State's parity laws;

          (C)  Individual and small group plans;

          (D)  Financial and durational limits on treatment;

          (E)  Determination of medical necessity;

          (F)  Managed care;

          (G)  Out-of-network coverage;

          (H)  Adequacy of network provider panels;

          (I)  Prescription medications;

          (J)  Specific services for serious mental illness;

          (K)  Oversight of implementation; and

          (L)  Independent external review of claims.

     (c)  The legislative reference bureau shall assist the working group in drafting any appropriate legislation.

     (d)  The working group shall submit to the legislature a report of its findings and recommendations, including proposed legislation, no later than twenty days prior to the convening of the regular session of 2021 and shall dissolve on June 30, 2022.

PART II

     SECTION 3.  The legislature finds that part V, Act 44, Session Laws of Hawaii 2004, established a successful insurance coverage parity provision for substance abuse treatment.  This provision lapsed on June 30, 2011.

     The purpose of this part is to reauthorize the provisions of part V, Act 44, Session Laws of Hawaii 2004, to ensure that substance abuse addiction is covered under a health insurance plan in the same way as a physical disease or illness.  Parity is extended to alcohol and drug abuse because these addictions are serious mental health illnesses that require equal treatment under health insurance plans.

     SECTION 4.  Chapter 431M, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

     "§431M-    Parity treatment for alcohol or drug dependency.  Unless greater benefits are required by this chapter for alcohol and substance abuse services and benefits, services and benefits provided by health insurance plans subject to section 431M-2 for drug and alcohol dependency shall be equal to and co-extensive with health insurance coverage for physical disease and illnesses.  Nothing in this section shall require the health insurance plan to provide residential treatment benefits except as it may provide for physical disease and illnesses and in accordance with an approved treatment plan by the health plan provider."

     SECTION 5.  Section 4 shall be exempt from the impact assessment report by the auditor under section 23-51, Hawaii Revised Statutes.  The legislature finds that an emergency situation continues to exist in the State that demands an immediate legislative response, and that the slight financial impact of a rise in premiums, as a result of reauthorizing parity provisions for substance abuse treatment insurance coverage, is likely to be incalculable (Auditor Report No. 88‑6).

     SECTION 6.  The treatment of drug and alcohol dependency provided under medical plans participating in QUEST and QUEST Expanded Access (QExA) shall be equal to and co-extensive with QUEST and QExA coverage for physical disease and illnesses.  Nothing in this section shall require QUEST and QExA to provide residential treatment benefits except as it may provide for physical disease and illnesses.

PART III

     SECTION 7.  New statutory material is underscored.

     SECTION 8.  This Act shall take effect upon its approval.

 

INTRODUCED BY:	_____________________________

 

 

Report Title:

Mental Health and Substance Abuse Parity; Working Group

 

Description:

Requires the director of health to convene a mental health and substance abuse parity working group to determine how the State can come into compliance with federal mental health and substance abuse parity laws and regulations and enhance existing state parity laws.  Reauthorizes, part V, Act 44, Session Laws of Hawaii 2004, providing parity for substance abuse treatment insurance coverage.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.