HLS 22RS-379 ORIGINAL
2022 Regular Session
HOUSE BILL NO. 278
BY REPRESENTATIVE ECHOLS
INSURANCE/HEALTH: Provides requirements for the psychiatric Collaborative Care
Model
1 AN ACT
2To enact R.S. 22:1066.2, relative to reimbursement for mental health and substance abuse
3 benefits provided through the psychiatric Collaborative Care Model service delivery
4 method; to provide for definitions; and to provide for related matters.
5Be it enacted by the Legislature of Louisiana:
6 Section 1. R.S. 22:1066.2 is hereby enacted to read as follows:
7 ยง1066.2. Psychiatric Collaborative Care Model; service delivery method
8 requirements
9 A.(1) A health coverage plan which is delivered or issued for delivery in this
10 state that provides mental health and substance abuse benefits shall provide
11 reimbursement for such benefits that are delivered through the psychiatric
12 Collaborative Care Model, which includes the following current procedural
13 terminology (CPT) billing codes established by the American Medical Association:
14 (a) 99492.
15 (b) 99493.
16 (c) 99494.
17 (2) The commissioner shall update this list of codes if there are any
18 alterations or additions to the billing codes for the Collaborative Care Model.
19 B. A health coverage plan may deny reimbursement of any CPT codes listed
20 in Subsection A of this Section on the grounds of medical necessity, provided that
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 22RS-379 ORIGINAL
HB NO. 278
1 such medical necessity determinations are in compliance with the Paul Wellstone
2 and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and its
3 related regulations, and that such determinations are made in accordance with the
4 Internal Claims and Appeals Process and External Review Act, R.S. 22:2391 et seq.
5 C. As used in this Section:
6 (1) "Health coverage plan" means any hospital, health, or medical expense
7 insurance policy, hospital or medical service contract, employee welfare benefit plan,
8 contract or agreement with a health maintenance organization or a preferred provider
9 organization, health and accident insurance policy, or any other insurance contract
10 of this type, including a group insurance plan and the Office of Group Benefits
11 programs.
12 (2) "Mental health or substance abuse benefits" means benefits for the
13 treatment of any condition or disorder that involves a mental health condition or
14 substance use disorder that falls under any of the diagnostic categories listed in the
15 mental disorders section of the current edition of the International Classification of
16 Diseases or that is listed in the mental disorders section of the most recent version
17 of the Diagnostic and Statistical Manual of Mental Disorders.
18 (3) "Psychiatric Collaborative Care Model" means the evidence-based,
19 integrated behavioral health service delivery method described in 81 FR 80230.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 278 Original 2022 Regular Session Echols
Abstract: Provides requirements for the psychiatric Collaborative Care Model and requires
mental health or substance abuse benefits for services delivered through the model.
Proposed law requires a health coverage plan delivered or issued for delivery in this state
that provides mental health and substance abuse benefits to reimburse for such benefits that
are delivered through the psychiatric Collaborative Care Model. The model includes the
current procedural terminology (CPT) billing codes 99492, 99493, and 99494.
Proposed law requires the commissioner of insurance to update the CPT codes if there are
any alterations or additions to the billing codes for the Collaborative Care Model.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 22RS-379 ORIGINAL
HB NO. 278
Proposed law authorizes a health coverage plan to deny reimbursement of any CPT code
provided in proposed law on the grounds of medical necessity, provided that such medical
necessity determinations are in compliance with certain federal and state law.
Proposed law defines "health coverage plan", "mental health or substance abuse benefits",
and "Psychiatric Collaborative Care Model"
(Adds R.S. 22:1066.2)
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.