Arkansas 2023 Regular Session

Arkansas Senate Bill SB178 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1	1		Stricken language would be deleted from and underlined language would be added to present law.
2		-	Act 615 of the Regular Session
3	2		ANS138 04-03-2023 13:14:57 ANS138
4	3
5	4		State of Arkansas As Engrossed: S2/9/23 S3/6/23 H4/3/23 1
6	5		94th General Assembly A Bill 2
7	6		Regular Session, 2023 SENATE BILL 178 3
8	7		4
9	8		By: Senators K. Hammer, Irvin 5
10	9		By: Representative Vaught 6
11	10		7
12	11		For An Act To Be Entitled 8
13	12		AN ACT TO AMEND THE ARKANSAS HEALTH CARE CONSUMER 9
14	13		ACT; TO PROVIDE REIM BURSEMENT AND BENEFI TS FOR MENTAL 10
15	14		ILLNESS AND SUBSTANC E USE DISORDERS THAT ARE 11
16	15		DELIVERED THROUGH A PSYCHIATRIC COLLABOR ATIVE CARE 12
17	16		MODEL; AND FOR OTHER PURPOSES. 13
18	17		14
19	18		15
20	19		Subtitle 16
21	20		TO AMEND THE ARKANSAS HEALTH CARE 17
22	21		CONSUMER ACT; AND TO PROVIDE 18
23	22		REIMBURSEMENT AND BENEFITS FOR MENTAL 19
24	23		ILLNESS AND SUBSTANCE USE DISORDERS THAT 20
25	24		ARE DELIVERED THROUGH A PSYCHIATRIC 21
26	25		COLLABORATIVE CARE MODEL. 22
27	26		23
28	27		24
29	28		BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF ARKANSAS: 25
30	29		26
31	30		SECTION 1. Arkansas Code Title 23, Chapter 99, Subchapter 4, is 27
32	31		amended to add an additional section to read as follows: 28
33	32		23-99-422. Benefits for mental illness or substance use disorders 29
34	33		delivered through psychiatric collaborative care m odel — Definitions — Rules. 30
35	34		(a) As used in this section: 31
36	35		(1)(A) “Healthcare insurer” means an insurance company, hospital 32
37	36		and medical service corporation, or health maintenance organization issuing 33
38	37		or delivering health benefit plans in this state and subject to the following 34
39	38		laws: 35
40	39		(i) The Arkansas Insurance Code; 36 As Engrossed: S2/9/23 S3/6/23 H4/3/23 SB178
41	40
42	41		2 04-03-2023 13:14:57 ANS138
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44	43
45	44		(ii) Section 23-76-101 et seq., pertaining to health 1
46	45		maintenance organizations; and 2
47	46		(iii) Section 23-75-101 et seq., pertaining to hospital 3
48	47		and medical service corporations; 4
49	48		(B) "Healthcare insurer" does not mean the Arkansas 5
50	49		Medicaid Program and Medicaid services provided under the Arkansas Medicaid 6
51	50		Program if those services are managed or reimbursed by another healthcare 7
52	51		insurer or a risk-based provider organization; and 8
53	52		(2) "Psychiatric collaborative care model" means the delivery of care 9
54	53		that is: 10
55	54		(A) An evidence-based, integrated behavioral health 11
56	55		service delivery method described at 81 Fed. Reg. 80230 -80239, as it existed 12
57	56		on March 31, 2023, and the MLN Booklet for Be havioral Health Integration 13
58	57		Services published by the Centers for Medicare & Medicaid Services, as it 14
59	58		existed on March 31, 2023; and 15
60	59		(B) A method typically used by a primary care team 16
61	60		consisting of a primary care provider and a care manager who works i n 17
62	61		collaboration with a psychiatric consultant, including without limitation a 18
63	62		psychiatrist. 19
64	63		(b) A healthcare insurer that provides benefits for the treatment of 20
65	64		mental illness or substance use disorders shall provide reimbursement for 21
66	65		those benefits if the benefits are delivered through a psychiatric 22
67	66		collaborative care model. 23
68	67		(c) The care provided by a primary care team shall: 24
69	68		(1) Be directed by the primary care team; 25
70	69		(2) Include structured care management with regular assessments 26
71	70		of clinical status using validated tools; and 27
72	71		(3) Include modification of treatment, as appropriate. 28
73	72		(d) A psychiatric consultant who participates in a primary care team 29
74	73		shall: 30
75	74		(1) Provide regular consultations to the primary care team; 31
76	75		(2) Review the clinical status and care of the covered person; 32
77	76		and 33
78	77		(3) Make recommendations. 34
79	78		(e)(1) A healthcare insurer may deny reimbursement for healthcare 35
80	79		services delivered through a psychiatric collaborative care model on the 36 As Engrossed: S2/9/23 S3/6/23 H4/3/23 SB178
81	80
82	81		3 04-03-2023 13:14:57 ANS138
83	82
84	83
85	84		grounds of medical necessity only if the medical necessity determinations are 1
86	85		in compliance with state law and the Paul Wellstone and Pete Domenici Mental 2
87	86		Health Parity and Addiction Equity Act of 2008, Pub. L. No. 110 -343, § 511 et 3
88	87		seq. 4
89	88		(2) For care provided through a psychiatric collaborative care 5
90	89		model, a healthcare insurer shall not: 6
91	90		(A) Place a benefit limitation or cap on the amount of 7
92	91		time, number of units, or dollar payments for care manager activities in any 8
93	92		month in a manner that is contrary to state law or the Paul Wellstone and 9
94	93		Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Pub. L. 10
95	94		No. 110-343, § 511 et seq.; 11
96	95		(B) Limit the ability of federally qualified health 12
97	96		centers or rural health clinics to receive reimbursement; 13
98	97		(C) Impose any licensure requirements enacted by state or 14
99	98		federal law for a care manager; 15
100	99		(D) Limit the age of a patient for whom the care is a 16
101	100		covered service; or 17
102	101		(E) Limit coverage to a patient with a specific diagnosis. 18
103	102		(f)(1) The Arkansas Medicaid Program may: 19
104	103		(A) Apply for a grant for a psychiatric 20
105	104		collaborative care model; and 21
106	105		(B) Work in consultation with nongovernmental 22
107	106		entities that are recognized to have expertise in psychiatric collaborative 23
108	107		care models. 24
109	108		(2) Beginning on September 1, 2023, and on a quarterly basis 25
110	109		thereafter, the Arkansas Medicaid Program shall report to the Senate 26
111	110		Committee on Insurance and Commerce and the House Committee on Insurance and 27
112	111		Commerce concerning the progress and activities under subdivision (f)(1) of 28
113	112		this section. 29
114	113		(g) The Insurance Commissioner may promulgate rules necessary to 30
115	114		implement this section. 31
116	115		32
117	116		SECTION 2. DO NOT CODIFY. EFFECTIVE DATE. This act is effective on 33
118	117		and after October 1, 2023. 34
119	118		35
120		-	36 As Engrossed: S2/9/23 S3/6/23 H4/3/23 SB178
121		-
122		-	4 04-03-2023 13:14:57 ANS138
123		-
124		-
125		-	1
126		-	APPROVED: 4/11/23 2
127		-	3
	119	+	/s/K. Hammer 36