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 Section 38a-488e of the general statutes is repealed and the 12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