HLS 22RS-379 ENGROSSED
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 relative to health coverage plans issued for delivery in this state
5 and Medicaid state plans; to provide for definitions; and to provide for related
6 matters.
7Be it enacted by the Legislature of Louisiana:
8 Section 1. R.S. 22:1066.2 is hereby enacted to read as follows:
9 ยง1066.2. Psychiatric Collaborative Care Model; service delivery method
10 requirements
11 A. A health coverage plan which is delivered or issued for delivery in this
12 state and any Medicaid state plan that provides mental health and substance abuse
13 benefits shall provide reimbursement for such benefits that are delivered through the
14 Psychiatric Collaborative Care Model, which includes the following current
15 procedural terminology (CPT) billing codes established by the American Medical
16 Association.
17 B. Any medical necessity determination made by a health coverage plan or
18 Medicaid state plan shall be in compliance with the Paul Wellstone and Pete
19 Domenici Mental Health Parity and Addiction Equity Act of 2008 and its related
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HLS 22RS-379 ENGROSSED
HB NO. 278
1 regulations, and that such determinations are made in accordance with the Internal
2 Claims and Appeals Process and External Review Act, R.S. 22:2391 et seq.
3 C. As used in this Section:
4 (1) "Health coverage plan" means any hospital, health, or medical expense
5 insurance policy, hospital or medical service contract, employee welfare benefit plan,
6 contract or agreement with a health maintenance organization or a preferred provider
7 organization, health and accident insurance policy, or any other insurance contract
8 of this type, including a group insurance plan and the Office of Group Benefits
9 programs.
10 (2) "Mental health or substance abuse benefits" means benefits for the
11 treatment of any condition or disorder that involves a mental health condition or
12 substance use disorder that falls under any of the diagnostic categories listed in the
13 mental disorders section of the current edition of the International Classification of
14 Diseases or that is listed in the mental disorders section of the most recent version
15 of the Diagnostic and Statistical Manual of Mental Disorders.
16 (3) "Psychiatric Collaborative Care Model" means the evidence-based,
17 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 Engrossed 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
and any Medicaid state plan that provides mental health and substance abuse benefits to
reimburse for services delivered through the Psychiatric Collaborative Care Model.
Proposed law requires any medical necessity determinations made by a health coverage plan
or Medicaid state plan to be 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. HLS 22RS-379 ENGROSSED
HB NO. 278
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Insurance to the
original bill:
1. Add Medicaid state plans for applicability within proposed law.
2. Delete certain CPT billing codes from specific application in proposed law.
3. Delete language relative to the commissioner of insurance updating CPT billing
codes and denial of reimbursement of CPT billing codes.
4. Make technical changes.
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.