Brief ⁽¹⁾

Senate Sub. for HB 2033 concerns health insurance for mental illness.

Requirements. The bill requires, on and after January 1, 2002, all group health insurance policies, medical service plans, contracts, hospital service corporation contracts, hospital and medical service corporation contracts, fraternal benefit society, or health maintenance organizations which provide coverage for mental health benefits to include coverage for the diagnosis and treatment of mental illness under terms and conditions no less extensive than coverage for any other type of health care.

Definition. "Mental illness" means: schizophrenia, schizoaffective disorder, schizophreniform disorder, brief reactive psychosis, paranoid or delusional disorder, atypical psychosis, major affective disorders (bipolar and major depression), cyclothymic and dysthymic disorders, obsessive compulsive disorder, panic disorder, pervasive developmental disorder, including autism, attention deficit disorder, and attention deficit hyperactive disorder.

Coverage Limitations. The mental illness benefit must include annual coverage for both 45 days of in-patient care for mental illness and for 45 days of out-patient care for mental illness. Coverage required by the bill does not apply to evaluations and diagnostic tests ordered or requested in connection with divorce, child custody, or child visitation proceedings.

• Managed Care Applicable. Managed care programs may be used in the implementation of the mental illness benefit as long as programs are applied equally to all coverages under the managed health care plan.
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• Drug Coverage. Additionally, on the effective date of the required mental illness coverage, group health insurance policies, nonprofit medical and hospital service corporation contracts, fraternal benefit societies, health maintenance organizations, municipal group funded pool, and the state employee benefit program which provide coverage for prescription drugs, also must provide coverage for psychotherapeutic drugs used for the treatment of mental illness under terms and conditions no less favorable than coverage for other prescription drugs.

Reporting. On or before January 1, 2005, the Insurance Department is to deliver a report to the President of the Senate and to the Speaker of the House of Representatives indicating the impact of providing mental illness benefits required by this bill. The report will include information regarding access to and usage of such services and the cost of those services.

Current Law Changes. Finally, the current law relating to the required health insurance coverage for the treatment of alcoholism, drug abuse, and nervous or mental conditions is amended to provide: that there is no coverage under that law for evaluations and diagnostic tests ordered or requested in connection with divorce, child custody, or child visitation proceedings; and that managed care programs may be used in the implementation of the alcoholism, drug abuse, and nervous or mental conditions treatment requirements.

Background

HB 2033 would have required the State Employees Health Care Commission to report to the President of the Senate and the Speaker of the House of Representatives the fiscal impact on the state health care benefits program of providing mental illness benefits for state employees in excess of the coverage currently required by law. The report, due on or before March 1, 2002, was to include a recommendation whether mental illness coverage should continue for state employees or whether additional data were required. Further, the report was to identify the costs specifically associated with the benefits provided for each of the conditions identified in the bill.

Proponents of Senate Sub. for HB 2033 explained that sufficient cost data and cost/benefit analyses exist now to justify passage of mental illness insurance coverage this session, as opposed to waiting for a report in 2002, and action on the report some time later. Supporters of the substitute bill include: Kansas Mental Health Coalition, Kansas Commission on Disability Concerns, Kansas Psychological Association, the Kansas Medical Association, National Association on Mental Illness, Keys for Networking, Inc., The Consortium, the Kansas State Nurses Association, the Association of Community Mental Health Centers, the Insurance Commissioner, the Chairperson of the Kansas Advisory Group on Juvenile Justice and former Secretary of Social and Rehabilitation Services, several parents, and other citizens.

Those opposed to the mental health parity issue include the Kansas Association of Health Plans, Blue Cross and Blue Shield of Kansas, Blue Cross and Blue Shield of Kansas City, the Health Insurance Association of America, and the Kansas Chamber of Commerce and Industry.

1. *Supplemental notes are prepared by the Legislative Research Department and do not express legislative intent. The supplemental note and fiscal note for this bill may be accessed on the Internet at http://www.ink.org/public/legislative/fulltext.cgi