LC 33 9827ERS The House Committee on Rules offers the following substitute to SB 131: A BILL TO BE ENTITLED AN ACT To amend Article 1 of Chapter 2 of Title 37 of the Official Code of Georgia Annotated,1 relating to general provisions regarding the administration of mental health, developmental2 disabilities, addictive diseases, and other disability services, so as to add a member to the3 Behavioral Health Coordinating Council; to establish a parity compliance review panel; to4 provide for its composition and duties; to require health care providers to report parity5 concerns to the panel; to provide for evaluation of parity concerns reported; to provide for6 recommendations for punitive actions; to provide for definitions; to provide for related7 matters; to repeal conflicting laws; and for other purposes.8 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:9 SECTION 1.10 Article 1 of Chapter 2 of Title 37 of the Official Code of Georgia Annotated, relating to11 general provisions regarding the administration of mental health, developmental disabilities,12 addictive diseases, and other disability services, is amended in Code Section 37-2-4, relating13 to the Behavioral Health Coordinating Council and its membership, meetings, and14 obligations, by revising subsections (a) and (c.1) and by adding a new subsection to read as15 follows:16 - 1 - LC 33 9827ERS "(a) There is created the Behavioral Health Coordinating Council. The council shall17 consist of the commissioner of behavioral health and developmental disabilities; the18 commissioner of early care and learning; the commissioner of community health; the19 commissioner of public health; the commissioner of human services; the commissioner of20 juvenile justice; the commissioner of corrections; the commissioner of veterans service; the21 commissioner of community supervision; the commissioner of community affairs; the22 commissioner of the Technical College System of Georgia; the Commissioner of Labor;23 the State School Superintendent; the Insurance Commissioner; the chairperson of the State24 Board of Pardons and Paroles; a behavioral health expert employed by the University25 System of Georgia, designated by the chancellor of the university system; two members,26 appointed by the Governor; the ombudsman appointed pursuant to Code Section 37-2-32;27 the Child Advocate for the Protection of Children; an expert on early childhood mental28 health, appointed by the Governor; an expert on child and adolescent health, appointed by29 the Governor; a pediatrician, appointed by the Governor; an adult consumer of public30 behavioral health services, appointed by the Governor; a family member of a consumer of31 public behavioral health services, appointed by the Governor; a parent of a child receiving32 public behavioral health services, appointed by the Governor; a member of the House of33 Representatives, appointed by the Speaker of the House of Representatives; and a member34 of the Senate, appointed by the President of the Senate."35 "(c.1) The commissioner of behavioral health and developmental disabilities, the36 commissioner of early care and learning, the commissioner of community health, the37 commissioner of public health, the commissioner of human services, the commissioner of38 juvenile justice, the commissioner of corrections, the commissioner of veterans service, the39 commissioner of community supervision, the commissioner of community affairs, the40 commissioner of the Technical College System of Georgia, the Commissioner of Labor,41 the State School Superintendent, the Insurance Commissioner, and the chairperson of the42 State Board of Pardons and Paroles shall each be authorized to be represented by a delegate43 - 2 - LC 33 9827ERS or agent at any meeting of the council or subcommittee meeting. Any such delegate or44 agent shall be counted toward a quorum, shall have all voting privileges as the member's45 delegate or agent, and shall not be considered an absence of the member."46 "(j) The council shall serve in an advisory role for the parity compliance review panel47 established pursuant to Code Section 37-2-12."48 SECTION 2.49 Said article is further amended by adding a new Code section to read as follows:50 "37-2-12.51 (a) As used in this Code section, the term:52 (1) 'Health care provider' means any health care professional licensed under Title 43 or53 any hospital or other health care facility licensed or regulated under Chapter 7 of Title 3154 or under this title.55 (2) 'Health insurer' has the same meaning as provided for in subsection (a) of Code56 Section 33-1-27.57 (3) 'Panel' means the parity compliance review panel established pursuant to this Code58 section.59 (4) 'Parity concerns' means actual or potential violations by health insurers and state60 health care entities of the requirements contained in:61 (A) Code Sections 33-1-27 and 33-21A-13, including, without limitation, the failure62 to use the statutory definitions of 'medically necessary' or 'generally accepted standards63 of mental health and substance use disorder care'; and64 (B) Code Section 33-24-59.10 and 42 U.S.C. Section 1905(r).65 (5) 'State health care entity' has the same meaning as provided for in subsection (a) of66 Code Section 33-21A-13.67 (b) There is established a parity compliance review panel within the council to be68 composed of:69 - 3 - LC 33 9827ERS (1) The following members of the council:70 (A) The commissioner of community health, or his or her designee;71 (B) The commissioner of behavioral health and developmental disabilities, or his or her72 designee;73 (C) The commissioner of human services, or his or her designee; and74 (D) The Insurance Commissioner, or his or her designee; and75 (2) The following appointed members:76 (A) Two mental health clinicians, appointed by the Governor;77 (B) Two senior executives of facilities or systems providing mental health care,78 appointed by the Governor;79 (C) One mental health advocate, appointed by the President of the Senate; and80 (D) One mental health advocate, appointed by the Speaker of the House of81 Representatives.82 (c)(1) Health care providers shall be required to report parity concerns in the manner and83 pursuant to the forms and periodicity, if any, adopted by the panel.84 (2) Any such reports shall:85 (A) Enable the submission of information by health care providers of actions or86 practices of concern that are not specifically listed in a form; and87 (B) Recognize the need to distinguish reporting content relevant for health care88 providers in general hospitals, inpatient or residential psychiatric treatment facilities,89 and emergency department or outpatient settings.90 (3) The panel shall encourage feedback from health care providers during the91 development of any reporting form, including, without limitation, feedback provided to92 the two senior executives of facilities or systems providing mental health care appointed93 to the panel by the Governor.94 (4) The panel shall have no authority to impose financial penalties on a health care95 provider for failing to report a parity concern.96 - 4 - LC 33 9827ERS (d) The panel shall establish a simple and intuitive process to receive parity concerns97 reported by health care providers pursuant to subsection (c) of this Code section. The panel98 shall evaluate submitted parity concerns to determine whether a health insurer or state99 health care entity is in violation of mental health parity laws. Based on such evaluation,100 the panel shall make recommendations as to appropriate punitive actions, if any, that may101 be warranted for a health insurer to the Commissioner of Insurance for violations of Code102 Section 33-1-27 and for a state health care entity to the commissioner of community health103 for violations of Code Section 33-21A-13.104 (e) The panel shall be authorized to:105 (1) Receive and analyze required reports from insurance companies and health care106 providers;107 (2) Request additional information from health insurers or state health care entities108 regarding potential mental health parity violations, including determinations of medical109 necessity;110 (3) Create and review educational materials for consumers and health care providers111 relating to compliance with mental health parity laws. Such educational materials shall112 include information on the concept of mental health parity, individuals' rights, and the113 complaint processes established pursuant to subsection (e) of Code Section 33-1-27,114 subsection (e) of Code Section 33-21A-13, and subsection (d) of this Code section. All115 such educational materials shall be culturally and linguistically sensitive, to the extent116 practicable; available in multiple languages; widely distributed; and offered in various117 formats, such as on a public website, in a brochure, and in written documentation; and118 (4) Consult and coordinate with the Governor's office, the Department of Community119 Health, and the office of the Commissioner of Insurance to establish criteria and120 procedures for the panel in formulating recommendations relating to punitive action for121 insurance companies that are not compliant with mental health parity laws.122 - 5 - LC 33 9827ERS (f) Subject to available funds, the panel shall establish a team to support the work of the123 panel, including, but not limited to, research, report preparation, and creation of educational124 materials."125 SECTION 3.126 All laws and parts of laws in conflict with this Act are repealed.127 - 6 -