ENROLLED
ACT No. 457
2022 Regular Session
HOUSE BILL NO. 278
BY REPRESENTATIVES ECHOLS AND FREEMAN
1 AN ACT
2 To enact R.S. 22:1066.2, relative to health coverage plans; to require reimbursement for
3 mental health and substance abuse benefits provided through the Psychiatric
4 Collaborative Care Model service delivery method; to provide for applicability; to
5 provide for definitions; and to provide for related matters.
6 Be it enacted by the Legislature of Louisiana:
7 Section 1. R.S. 22:1066.2 is hereby enacted to read as follows:
8 ยง1066.2. Psychiatric Collaborative Care Model; service delivery method
9 requirements
10 A. A health coverage plan which is delivered or issued for delivery in this
11 state that provides mental health and substance abuse benefits shall provide coverage
12 for mental health and substance abuse services that are delivered through
13 evidence-based, integrated behavioral healthcare models, such as the Psychiatric
14 Collaborative Care Model.
15 B. Any medical necessity determination made by a health coverage plan
16 shall be in compliance with the Paul Wellstone and Pete Domenici Mental Health
17 Parity and Addiction Equity Act of 2008 and its related regulations, and in
18 accordance with the Internal Claims and Appeals Process and External Review Act,
19 R.S. 22:2391 et seq.
20 C. As used in this Section, the following terms apply:
21 (1) "Health coverage plan" means any hospital, health, or medical expense
22 insurance policy, hospital or medical service contract, employee welfare benefit plan,
23 contract or agreement with a health maintenance organization or a preferred provider
24 organization, health and accident insurance policy, or any other insurance contract
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions. HB NO. 278 ENROLLED
1 of this type, including a group insurance plan and the Office of Group Benefits
2 programs.
3 (2) "Mental health or substance abuse benefits" means benefits for the
4 treatment of any condition or disorder that involves a mental health condition or
5 substance use disorder that falls under any of the diagnostic categories listed in the
6 mental disorders section of the current edition of the International Classification of
7 Diseases or that is listed in the mental disorders section of the most recent version
8 of the Diagnostic and Statistical Manual of Mental Disorders.
9 (3) "Psychiatric Collaborative Care Model" means the evidence-based,
10 integrated behavioral health service delivery method that is typically provided by a
11 primary care team consisting of a primary care provider and a care manager who
12 works in collaboration with a psychiatric consultant, such as a psychiatrist. Care is
13 directed by the primary care team and includes structured care management with
14 regular assessments of clinical status using validated tools and modification of
15 treatment as appropriate. The psychiatric consultant provides regular consultations
16 to the primary care team to review the clinical status and care of patients and to make
17 recommendations.
18 Section 2. The provisions of this Act shall apply to any new health coverage plan
19 issued on or after January 1, 2023. Any health coverage plan in effect prior to January 1,
20 2023, shall convert to conform to the provisions of this Act on or before the renewal date,
21 but no later than January 1, 2024.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
PRESIDENT OF THE SENATE
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED:
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CODING: Words in struck through type are deletions from existing law; words underscored
are additions.