HB2406 HD1.DOC

SECTION 1. 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 treatment more accessible and affordable. The legislature finds that despite widespread concern and support across America, 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 health coverage 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 may not impose greater restrictions on mental health and substance abuse disorders than on medical or surgical benefits. The legislature finds that while the interim 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 will effectuate compliance with federal mental health and substance abuse parity laws and regulations and enhance the State's own existing parity laws.

SECTION 2. (a) The director of health shall convene a mental health and substance abuse parity working group which shall work in conjunction with the governor's health care transformation coordinator to carry out the purpose of this Act. Members of the working group shall not be subject to chapter 84, Hawaii Revised Statutes, solely due to the member's participation in the working group. The working group shall consist of eleven members as follows:

(1) One member appointed by the governor;

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

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

(4) One member appointed by the attorney general;

(5) One member appointed by the insurance commissioner;

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

(7) One member appointed by the adult mental health division of the department of health;

(8) One member who shall be a representative of the Hawaii Substance Abuse Coalition;

(9) One member who shall be a representative from a mental health advocacy and support organization;

(10) One member who shall be a representative from a clinical service organization; and

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

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

(1) Review special reports of the United States Department of the Treasury, 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 interim final rules issued to implement the requirements of that Act;

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

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

(B) Provisions that address the issue of behavioral health provider shortages by providing for the establishment of grant programs to train and educate such providers;

(C) 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; and

(D) Provisions that address research needs in specialty areas of mental health care, such as authorizing studies on postpartum depression;

(3) Determine the State's role and responsibilities in implementing the Paul Wellstone and Pete Domenici 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;

(D) Financial and durational limits on treatment;

(E) Determination of medical necessity;

(F) Regulation of managed care;

(G) Regulation of out-of-network coverage;

(H) Adequacy of network provider panels;

(I) Regulation of prescription medications;

(J) Provision of specific services for serious mental illness;

(K) Oversight of implementation;

(L) Independent external review of claims; and

(M) Prevention and de-stigmatization of mental health and substance abuse issues.

(c) The legislative reference bureau shall assist the working group in drafting any proposed legislation; provided that the working group shall submit a draft of its proposed legislation to the legislative reference bureau no later than November 1, 2013.

(d) The working group shall submit to the legislature a report of its findings and recommendations, including proposed legislation, on state compliance with federal law relating to mental health and substance abuse parity, including the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equality Act of 2008, at least twenty days prior to the regular session of 2014 and shall dissolve on June 30, 2014.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2012-2013 to fund the operations of the mental health and substance abuse parity working group.

The sum appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2050; provided that section 3 of this Act shall take effect on July 1, 2012.

HOUSE OF REPRESENTATIVES	H.B. NO.	2406
TWENTY-SIXTH LEGISLATURE, 2012		H.D. 1
STATE OF HAWAII