REPORT TITLE:
Mental Health Parity


DESCRIPTION:
Requires parity for in insurance coverage for mental health
benefits; defines serious mental illness as mental disorders as
defined in the Diagnostic and Statistical Manual, except for
specified conditions; deletes exception for employers with 25 or
fewer employees; clarifies duties of the Hawaii mental health
insurance task force.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                                                        2973
THE SENATE                              S.B. NO.           
TWENTIETH LEGISLATURE, 2000                                
STATE OF HAWAII                                            
                                                             
________________________________________________________________
________________________________________________________________


                     A BILL FOR AN ACT

RELATING TO MENTAL HEALTH INSURANCE COVERAGE.



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

 1      SECTION 1.  Section 431M-1, Hawaii Revised Statutes, is
 
 2 amended by amending the definition of "serious mental illness" to
 
 3 read:
 
 4      ""Serious mental illness" means [schizophrenia, schizo-
 
 5 affective disorder, and bipolar mood disorder, as defined in the
 
 6 most recent version of the Diagnostic and Statistical Manual of
 
 7 the American Psychiatric Association, which is of sufficient
 
 8 severity to result in substantial interference with the
 
 9 activities of daily living.] mental disorders, as defined in the
 
10 most recent edition of the American Psychiatric Association's
 
11 Diagnostic and Statistic Manual of Mental Disorders, including
 
12 mental or nervous conditions; provided that the term does not
 
13 include mental retardation, learning disorders, motor skills
 
14 disorders, communication disorders, caffeine-related disorders,
 
15 relational problems, and other conditions as the subject of
 
16 clinical attention, if these terms are not defined as mental
 
17 disorders in the most recent edition of the American Psychiatric
 
18 Association's Diagnostic and Statistic Manual of Mental
 
19 Disorders."
 

 
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 1      SECTION 2.  Section 431M-2, Hawaii Revised Statutes, is
 
 2 amended to read as follows:
 
 3      "[[]§431M-2[]]  Policy coverage.  All individual and group
 
 4 accident and sickness insurance policies issued in this State,
 
 5 individual or group hospital or medical service plan contracts,
 
 6 and nonprofit mutual benefit association and health maintenance
 
 7 organization health plan contracts shall include within their
 
 8 hospital and medical coverage the benefits [of] for alcohol
 
 9 dependence, drug dependence, and mental illness treatment
 
10 services provided in section 431M-4 except that this section
 
11 shall not apply to insurance policies that are issued solely for
 
12 single diseases, or otherwise limited, specialized coverage[.];
 
13 provided that benefits for mental illness and serious mental
 
14 illness treatment shall cover adults and children and be under
 
15 the same terms and conditions as coverage provided for other
 
16 illnesses and conditions."
 
17      SECTION 3.  Section 431M-5, Hawaii Revised Statutes, is
 
18 amended by amending subsection (c) to read as follows:
 
19      "(c)  A health insurance plan shall not impose rates, terms,
 
20 or conditions including service limits and financial
 
21 requirements, on serious mental illness benefits, if similar
 
22 rates, terms, or conditions are not applied to services for other
 
23 medical or surgical conditions.  This [subsection shall not]
 

 
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                                     S.B. NO.           
                                                        
                                                        

 
 1 chapter shall apply to individual or group hospital or medical
 
 2 service plan contracts, and nonprofit mutual benefit association
 
 3 and health maintenance organization health plan contracts
 
 4 [providing coverage to employers with twenty-five or fewer
 
 5 employees, and], government employee health benefits plans under
 
 6 chapter 87[;], and [provided further that this subsection shall
 
 7 not apply to] QUEST medical plans under the department of human
 
 8 services [until July 1, 2002]."
 
 9      SECTION 4.  Act 121, Session Laws of Hawaii 1999, is amended
 
10 by amending subsections (c), (d), and (e) to read as follows:
 
11      "(c)  The task force shall:
 
12      (1)  Investigate ways to define and quantify unmet mental
 
13           health and substance abuse needs in the State, and
 
14           shall analyze possible outcome data collection measures
 
15           in order to meaningfully measure and describe:
 
16           (A)  The efficacy of mental health and substance abuse
 
17                treatment in the State; and
 
18           (B)  Unmet mental health and substance abuse treatment
 
19                needs;
 
20      (2)  Describe mental health and substance abuse coverage in
 
21           the State, including deductibles, copayments, and
 
22           covered illnesses and conditions;
 
23      (3)  Describe the relative costs of mental illness and
 

 
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                                     S.B. NO.           
                                                        
                                                        

 
 1           substance abuse coverage, and other health coverage in
 
 2           the State;
 
 3      (4)  Describe mental health and substance abuse treatment
 
 4           utilization in the State by adults, adolescents, and
 
 5           children;
 
 6      (5)  Produce an analysis of the needs of individuals who
 
 7           have exhausted their mental health or substance abuse
 
 8           treatment benefits;
 
 9      (6)  Determine the effect of mandated serious mental illness
 
10           benefits parity on mental health and substance abuse
 
11           services consumers, affected health plans, businesses,
 
12           and other concerned parties, including a review of the
 
13           experience of health plans in providing the coverage,
 
14           and an assessment of any impact on costs, services
 
15           provided, and services utilization[; and
 
16      (7)  Develop treatment and utilization guidelines for
 
17           severe, biologically-based mental illnesses in addition
 
18           to those covered under this Act, including, but not
 
19           limited to:
 
20           (A)  Major depression;
 
21           (B)  Obsessive compulsive disorders;
 
22           (C)  Severe panic disorders;
 
23           (D)  Autism and pervasive development disorders;
 

 
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 1           (E)  Multiple personality disorder (disassociative
 
 2                disorder);
 
 3           (F)  Brain damage or disfunction as defined by
 
 4                neuropsychological testing; and
 
 5           (G)  Other severe and disabling mental disorders such
 
 6                as severe anorexia, severe attention-
 
 7                deficit/hyperactivity disorder, and severe
 
 8                dyslexia].
 
 9      (d)  The task force shall perform its duties as follows:
 
10      (1)  [The task force shall not utilize any moneys from the
 
11           general fund to support its functions.]  Members shall
 
12           serve without compensation;
 
13      (2)  A simple majority of the members of the task force
 
14           shall constitute a quorum for the transaction of
 
15           business, and all actions of the task force shall
 
16           require the affirmative vote of a majority of the
 
17           members present;
 
18      (3)  The task force may hold public hearings as frequently
 
19           as deemed necessary and feasible to receive testimony
 
20           on issues relative to the task force's investigation;
 
21           and
 
22      (4)  The task force may invite participants, including the
 
23           auditor or the auditor's representative, as deemed
 

 
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 1           necessary to effectuate its purposes.
 
 2      (e)  The task force shall submit a report of its findings
 
 3 and recommendations to the speaker of the house of
 
 4 representatives, the president of the senate, and the governor no
 
 5 later than twenty days before the convening of the regular
 
 6 session of 2001, and shall be dissolved upon submittal of its
 
 7 report.  [Provided that the task force shall submit the report of
 
 8 its findings and recommendations concerning treatment and
 
 9 utilization guidelines as required under subsection (c)(7) of
 
10 this section, to the speaker of the house of representatives, the
 
11 president of the senate, and the governor no later than twenty
 
12 days before the convening of the regular session of 2000.]"
 
13      SECTION 5.  Statutory material to be repealed is bracketed.
 
14 New statutory material is underscored.
 
15      SECTION 6.  This Act shall take effect on July 1, 2002, and
 
16 shall apply to policies issued or renewed after December 31,
 
17 2002; provided that section 4 shall take effect upon its
 
18 approval.
 
19 
 
20                           INTRODUCED BY:________________________