HB 796 -- Mental Health Insurance Coverage

Sponsor:  Lampe

This bill requires all health carriers offering health benefit
plans which are delivered, issued, continued, or renewed on or
after August 28, 2009, to provide coverage for mental health
conditions if allowed under federal mental health parity laws as
follows:

(1)   A health carrier can limit the number of inpatient or
residential treatments for alcoholism to 30 days or a health
carrier can limit substance abuse coverage for outpatient
treatment programs to 26 days, residential treatment programs to
21 days, and detox programs to six days.  Coverage for substance
use disorders may be subject to a lifetime maximum of 10 episodes
of treatment; and

(2)  Carriers cannot deny or refuse to issue insurance coverage
on, refuse to contract with, or refuse to renew or reissue,
terminate, or restrict coverage on an individual or his or her
dependent solely because of being diagnosed with autism spectrum
disorder (ASD).  The coverage provided by an insurance carrier
for ASD is limited to treatment ordered by the insured
individual's licensed treating physician or psychologist in
accordance with a treatment plan.  Except for inpatient services,
the health benefit plan or carrier can request a review of the
treatment not more than once every six months at their expense
unless the individual's treating physician or psychologist agrees
that a more frequent review is necessary.  Applied behavior
analysis treatments for individuals younger than 21 years of age
must be covered by the health plan and will have a maximum
benefit of $72,000 per year with no limit on the number of times
an individual visits an autism service provider.  After December
31, 2010, the Director of the Department of Insurance, Financial
Institutions and Professional Registration must annually adjust
the maximum benefit based upon the percentage of increase in the
federal Consumer Price Index.

Any health carrier violating the provisions of the bill will be
subject to a fine enforceable by the department.

The bill repeals certain provisions of law to consolidate,
streamline, and update the laws regarding mental health insurance
coverage due to the new federal parity requirements.

Missouri House of Representatives
95th General Assembly, 1st Regular Session
Last Updated November 17, 2009 at 9:25 am