CODING: Words stricken are deletions; words underlined are additions.House Bill 0041
    Florida House of Representatives - 1997                  HB 41
        By Representative Brennan
  1                      A bill to be entitled
  2         An act relating to health insurance; providing
  3         a short title; providing application; amending
  4         s. 627.668, F.S.; providing that the current
  5         requirement for group insurers to offer
  6         coverage for mental health conditions does not
  7         apply to serious mental illness; creating s.
  8         627.6681, F.S.; requiring group health insurers
  9         and health maintenance organizations to provide
10         coverage for serious mental illness; requiring
11         benefits to be the same as for physical illness
12         generally; requiring the health benefit plan
13         committee to consider and recommend
14         modifications to standard, basic, and limited
15         health benefit plans; providing definitions;
16         providing an appropriation; providing a
17         description of state interest; providing an
18         effective date.
19
20  Be It Enacted by the Legislature of the State of Florida:
21
22         Section 1.  This act may be cited as the "Mental
23  Illness Insurance Parity Act."
24         Section 2.  Section 627.668, Florida Statutes, is
25  amended to read:
26         627.668  Optional coverage for mental and nervous
27  disorders required; exception.--
28         (1)  Every insurer, health maintenance organization,
29  and nonprofit hospital and medical service plan corporation
30  transacting group health insurance or providing prepaid health
31  care in this state shall make available to the policyholder as
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    Florida House of Representatives - 1997                  HB 41
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  1  part of the application, for an appropriate additional premium
  2  under a group hospital and medical expense-incurred insurance
  3  policy, under a group prepaid health care contract, and under
  4  a group hospital and medical service plan contract, the
  5  benefits or level of benefits specified in subsection (2) for
  6  the necessary care and treatment of mental and nervous
  7  disorders, as defined in the standard nomenclature of the
  8  American Psychiatric Association, except this section shall
  9  not apply to coverage for serious mental illness as defined in
10  s. 627.6681.  The coverage required in this section shall be
11  subject to the right of the applicant for a group policy or
12  contract to select any alternative benefits or level of
13  benefits as may be offered by the insurer, health maintenance
14  organization, or service plan corporation provided that, if
15  alternate inpatient, outpatient, or partial hospitalization
16  benefits are selected, such benefits shall not be less than
17  the level of benefits required under paragraph (2)(a),
18  paragraph (2)(b), or paragraph (2)(c), respectively.
19         (2)  Under group policies or contracts, inpatient
20  hospital benefits, partial hospitalization benefits, and
21  outpatient benefits provided pursuant to this section,
22  consisting of durational limits, dollar amounts, deductibles,
23  and coinsurance factors shall not be less favorable than for
24  physical illness generally, except that:
25         (a)  Inpatient benefits may be limited to not less than
26  30 days per benefit year as defined in the policy or contract.
27  If inpatient hospital benefits are provided beyond 30 days per
28  benefit year, the durational limits, dollar amounts, and
29  coinsurance factors thereto need not be the same as applicable
30  to physical illness generally.
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    Florida House of Representatives - 1997                  HB 41
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  1         (b)  Outpatient benefits may be limited to $1,000 for
  2  consultations with a licensed physician, a psychologist
  3  licensed pursuant to chapter 490, a mental health counselor
  4  licensed pursuant to chapter 491, a marriage and family
  5  therapist licensed pursuant to chapter 491, and a clinical
  6  social worker licensed pursuant to chapter 491.  If benefits
  7  are provided beyond the $1,000 per benefit year, the
  8  durational limits, dollar amounts, and coinsurance factors
  9  thereof need not be the same as applicable to physical illness
10  generally.
11         (c)  Partial hospitalization benefits shall be provided
12  under the direction of a licensed physician.  For purposes of
13  this part, the term "partial hospitalization services" is
14  defined as those services offered by a program accredited by
15  the Joint Commission on Accreditation of Hospitals (JCAH) or
16  in compliance with equivalent standards. Alcohol
17  rehabilitation programs accredited by the Joint Commission on
18  Accreditation of Hospitals or approved by the state and
19  licensed drug abuse rehabilitation programs shall also be
20  qualified providers under this section.  In any benefit year,
21  if partial hospitalization services or a combination of
22  inpatient and partial hospitalization are utilized, the total
23  benefits paid for all such services shall not exceed the cost
24  of 30 days of inpatient hospitalization for psychiatric
25  services, including physician fees, which prevail in the
26  community in which the partial hospitalization services are
27  rendered.  If partial hospitalization services benefits are
28  provided beyond the limits set forth in this paragraph, the
29  durational limits, dollar amounts, and coinsurance factors
30  thereof need not be the same as those applicable to physical
31  illness generally.
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  1         (3)  Insurers providing coverage pursuant to this
  2  section and s. 627.6681 must maintain strict confidentiality
  3  regarding psychiatric and psychotherapeutic records submitted
  4  to an insurer for the purpose of reviewing a claim for
  5  benefits payable under this section.  These records submitted
  6  to an insurer are subject to the limitations of s. 455.241,
  7  relating to the furnishing of patient records.
  8         Section 3.  Section 627.6681, Florida Statutes, is
  9  created to read:
10         627.6681  Coverage for serious mental illness
11  required.--
12         (1)  Every insurer and health maintenance organization
13  transacting group health insurance or providing prepaid health
14  care in this state shall provide as part of such insurance or
15  health care under a group hospital and medical
16  expense-incurred insurance policy, or under a group prepaid
17  health care contract, coverage for the treatment of serious
18  mental illness, which treatment is determined to be medically
19  necessary.  When a diagnosis of serious mental illness is
20  accompanied by substance abuse, treatment for the patient who
21  is dually diagnosed shall include, but not be limited to,
22  treatment for substance abuse.
23         (2)  Under group policies or contracts, inpatient
24  hospital benefits, partial hospitalization benefits, and
25  outpatient benefits consisting of durational limits, dollar
26  amounts, deductibles, and coinsurance factors shall be the
27  same for serious mental illness as for physical illness
28  generally.
29         (3)  The standard, basic, and limited health benefit
30  plan committee, duly appointed in the manner provided in s.
31  627.6699(12)(a)1., shall consider the modification of the
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  1  standard, basic, and limited health benefit plans developed
  2  pursuant to s. 627.6699(12), to include coverage for serious
  3  mental illness as prescribed in this section.  The committee
  4  shall submit any recommended modifications to the department
  5  for approval.
  6         (4)  As used in this section, the term "serious mental
  7  illness" means any mental illness that is recognized in the
  8  latest edition of relevant manuals of the American Psychiatric
  9  Association or by the International Classification of
10  Diseases, and affirmed by medical science as caused by
11  biological disorder of the brain, and that substantially
12  limits the life activities of the patient.  The term includes,
13  but is not limited to, schizophrenia, schizoaffective
14  disorders, anxiety and panic disorders, bipolar affective
15  disorders, major depression, and obsessive compulsive
16  disorder.
17         Section 4.  There is hereby appropriated to the
18  Department of Insurance from the Insurance Commissioner's
19  Regulatory Trust Fund for fiscal year 1997-1998 one full-time
20  equivalent position and $38,288 to implement the provisions of
21  this act.
22         Section 5.  The provisions of this bill fulfill an
23  important state interest in that they promote the relief and
24  alleviation of health or medical problems that affect
25  significant portions of the state's population.  The bill, in
26  requiring insurance coverage, should facilitate closer
27  scrutiny of the treatment of these conditions, resulting in
28  more cost-efficient and effective treatment of such
29  conditions.  By improving the overall level and quality of
30  health care, the bill will have the effect of reducing total
31  costs of medical plans under which treatment is provided for
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  1  these conditions, thereby reducing public medical assistance
  2  benefits as well as outlays for persons covered under all
  3  medical plans.
  4         Section 6.  This act shall take effect October 1, 1997,
  5  and shall apply to any policy issued, written, or renewed in
  6  this state on or after such date.
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  9                          HOUSE SUMMARY
10    Creates the "Mental Illness Insurance Parity Act."
      Provides that the current requirement for group insurers
11    to offer coverage for mental health conditions does not
      apply to serious mental illness.  Requires group health
12    insurers and health maintenance organizations to provide
      coverage for serious mental illness and requires benefits
13    to be the same as for physical illness generally.  See
      bill for details.
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