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General Assembly Substitute Bill No. 6643
January Session, 2023
AN ACT CONCERNING MEDICAID REIMBURSEMENT FOR MENTAL
HEALTH AND SUICIDE RISK ASSESSMENTS CONDUCTED AT
SCHOOL-BASED HEALTH CENTERS AND INSURANCE COVERAGE
FOR THE PROVISION OF MENTAL HEALTH WELLNESS
EXAMINATIONS.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. (NEW) (Effective July 1, 2023) (a) The Commissioner of 1
Social Services shall provide Medicaid reimbursement, to the extent 2
permissible under federal law, for suicide risk assessments and other 3
mental health evaluations and services provided at a school-based 4
health center or at a public school. 5
(b) The Commissioner of Social Services shall amend the Medicaid 6
state plan if necessary to provide reimbursement for the suicide risk 7
assessments and mental health evaluations and services described in 8
subsection (a) of this section and shall set reimbursement at a level 9
adequate to ensure an adequate pool of providers for such suicide risk 10
assessments and mental health evaluations and services. 11
Sec. 2. Section 38a-488e of the general statutes is repealed and the 12
following is substituted in lieu thereof (Effective from passage): 13
(a) For the purposes of this section: 14
(1) "Licensed mental health professional" means: (A) A licensed 15 Substitute Bill No. 6643
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professional counselor or professional counselor, both as defined in 16
section 20-195aa; (B) a person who is under professional supervision, 17
as defined in section 20-195aa; (C) a physician licensed pursuant to 18
chapter 370, who is certified in psychiatry by the American Board of 19
Psychiatry and Neurology; (D) an advanced practice registered nurse 20
licensed pursuant to chapter 378, who is certified as a psychiatric and 21
mental health clinical nurse specialist or nurse practitioner by the 22
American Nurses Credentialing Center; (E) a psychologist licensed 23
pursuant to chapter 383; (F) a marital and family therapist licensed 24
pursuant to chapter 383a; (G) a licensed clinical social worker licensed 25
pursuant to chapter 383b; or (H) an alcohol and drug counselor 26
licensed under chapter 376b; and 27
(2) "Mental health wellness examination" means a screening or 28
assessment that seeks to identify any behavioral or mental health 29
needs and appropriate resources for treatment. The examination may 30
include: (A) Observation; (B) a behavioral health screening; (C) 31
education and consultation on healthy lifestyle changes; (D) referrals 32
to ongoing treatment, mental health services and other necessary 33
supports; (E) discussion of potential options for medication; (F) age-34
appropriate screenings or observations to understand the mental 35
health history, personal history and mental or cognitive state of the 36
person being examined; and (G) if appropriate, relevant input from an 37
adult through screenings, interviews or questions. [;] 38
[(3) "Primary care provider" has the same meaning as provided in 39
section 19a-7o; and 40
(4) "Primary care" has the same meaning as provided in section 19a-41
7o.] 42
(b) (1) Each individual health insurance policy providing coverage 43
of the type specified in subdivisions (1), (2), (4), (11) and (12) of section 44
38a-469 and delivered, issued for delivery, renewed, amended or 45
continued in this state on or after January 1, 2023, (A) shall provide 46
coverage for two mental health wellness examinations per year that 47 Substitute Bill No. 6643
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are performed by a licensed mental health professional, [or primary 48
care provider,] and (B) shall not require prior authorization of such 49
examinations. 50
(2) The mental health wellness examinations [: (A) May each be 51
provided by a primary care provider as part of a preventive visit; and 52
(B)] shall be covered with no patient [cost-sharing] cost sharing. 53
(c) The provisions of this section shall apply to a high deductible 54
health plan, as that term is used in subsection (f) of section 38a-493, to 55
the maximum extent permitted by federal law, except if such plan is 56
used to establish a medical savings account or an Archer MSA 57
pursuant to Section 220 of the Internal Revenue Code of 1986, as 58
amended from time to time, or any subsequent corresponding Internal 59
Revenue Code of the United States, as amended from time to time, or a 60
health savings account pursuant to Section 223 of said Internal 61
Revenue Code of 1986, as amended from time to time, the provisions 62
of this section shall apply to such plan to the maximum extent that (1) 63
is permitted by federal law, and (2) does not disqualify such account 64
for the deduction allowed under said Section 220 or 223, as applicable. 65
Sec. 3. Section 38a-514e of the general statutes is repealed and the 66
following is substituted in lieu thereof (Effective from passage): 67
(a) For the purposes of this section: 68
(1) "Licensed mental health professional" means: (A) A licensed 69
professional counselor or professional counselor, as defined in section 70
20-195aa; (B) a person who is under professional supervision, as 71
defined in section 20-195aa; (C) a physician licensed pursuant to 72
chapter 370, who is certified in psychiatry by the American Board of 73
Psychiatry and Neurology; (D) an advanced practice registered nurse 74
licensed pursuant to chapter 378, who is certified as a psychiatric and 75
mental health clinical nurse specialist or nurse practitioner by the 76
American Nurses Credentialing Center; (E) a psychologist licensed 77
pursuant to chapter 383; (F) a marital and family therapist licensed 78 Substitute Bill No. 6643
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pursuant to chapter 383a; (G) a licensed clinical social worker licensed 79
pursuant to chapter 383b; or (H) an alcohol and drug counselor 80
licensed under chapter 376b; and 81
(2) "Mental health wellness examination" means a screening or 82
assessment that seeks to identify any behavioral or mental health 83
needs and appropriate resources for treatment. The examination may 84
include: (A) Observation; (B) a behavioral health screening; (C) 85
education and consultation on healthy lifestyle changes; (D) referrals 86
to ongoing treatment, mental health services and other necessary 87
supports; (E) discussion of potential options for medication; (F) age-88
appropriate screenings or observations to understand the mental 89
health history, personal history and mental or cognitive state of the 90
person being examined; and (G) if appropriate, relevant input from an 91
adult through screenings, interviews or questions. [;] 92
[(3) "Primary care provider" has the same meaning as provided in 93
section 19a-7o; and 94
(4) "Primary care" has the same meaning as provided in section 19a-95
7o.] 96
(b) (1) Each group health insurance policy providing coverage of the 97
type specified in subdivisions (1), (2), (4), (11) and (12) of section 38a-98
469 and delivered, issued for delivery, renewed, amended or 99
continued in this state on or after January 1, 2023, (A) shall provide 100
coverage for two mental health wellness examinations per year that 101
are performed by a licensed mental health professional, [or primary 102
care provider,] and (B) shall not require prior authorization of such 103
examinations. 104
(2) The mental health wellness examinations [: (A) May each be 105
provided by a primary care provider as part of a preventive visit; and 106
(B)] shall be covered with no patient [cost-sharing] cost sharing. 107
(c) The provisions of this section shall apply to a high deductible 108
health plan, as that term is used in subsection (f) of section 38a-520, to 109 Substitute Bill No. 6643
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the maximum extent permitted by federal law, except if such plan is 110
used to establish a medical savings account or an Archer MSA 111
pursuant to Section 220 of the Internal Revenue Code of 1986, as 112
amended from time to time, or any subsequent corresponding Internal 113
Revenue Code of the United States, as amended from time to time, or a 114
health savings account pursuant to Section 223 of said Internal 115
Revenue Code, as amended from time to time, the provisions of this 116
section shall apply to such plan to the maximum extent that (1) is 117
permitted by federal law, and (2) does not disqualify such account for 118
the deduction allowed under said Section 220 or 223, as applicable. 119
This act shall take effect as follows and shall amend the following
sections:
Section 1 July 1, 2023 New section
Sec. 2 from passage 38a-488e
Sec. 3 from passage 38a-514e
KID Joint Favorable Subst.