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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
COMMITTEE SUBSTITUTE
FOR
SENATE BILL 444 By: Montgomery of the Senate
and
Miller of the House
COMMITTEE SUBSTITUTE
An Act relating to mental health and substance use
disorder benefits; defining terms; requiring certain
health benefit plans and Oklahoma Medicaid Program to
provide reimbursement for certain care pursuant to
certain models; allowing for denial of reimburse ment
under certain circumstances; providing for necessity
determination; providing for codification ; and
providing an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statu tes as Section 6060.11a of Title 36, unless
there is created a duplica tion in numbering, reads as follows:
A. For the purposes of this section:
1. “Behavioral health integration” means an approach to
delivering mental health care that improves the ability for primary
care providers to include mental and behavioral health screening,
treatment, and specialty care i nto their practice pursuant to
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current procedural terminology billing code 99484, as established by
the American Medical Association ;
2. “Health benefit plan” means a plan as defined pur suant to
Section 6060.4 of Title 36 of the Oklahoma Statutes;
3. “Mental health and substanc e abuse disorder benefits” means
benefits for the treatment of any condition or disord er that
involves a mental health condition or substance abuse disorder ,
including but not limited to those that fall under any of the
diagnostic categories listed in the mental disorder s section of the
most recent edition of the International Classificatio n of Diseases
or in the mental disorders section of the most recent version of the
Diagnostic and Statistical Manual of Mental Disorders;
4. “Oklahoma Medicaid Program” means the state program
administered by the Oklahoma Health Care Authority pursuant to
Section 1002 of Title 56 of the Oklahoma Statutes; and
5. “Psychiatric collaborative care model” means the evidence-
based, integrated behavioral health service delivery method
described pursuant to 81 C.F.R. 80230. The model shall include, but
not be limited to, the following current procedural terminology
billing codes, as established by the American Medical Association:
a. 99492,
b. 99493, and
c. 99494.
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B. 1. Any health benefit plan that is offered, issued, or
renewed in this state and tha t provides mental health or substance
abuse disorder benefits shall provide reimbursement for such
benefits that are delivered through the behavioral health
integration and psychiatric collaborative care models.
2. The Oklahoma Medicaid Program shall provide re imbursement
for such benefits that are delivered through the behavioral health
integration and psychiatric collaborative care models.
3. Plans offered, issued, or renewed in this state that provide
benefits under this subsection may deny reimbursement of any current
procedural terminology code pursuant to paragraph 3 of subsection A
of this section due to medical necessity ; provided, such medical
necessity determinations shall be in compliance with the federal
Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
Equity Act of 2008, as amended, and its implementing and related
regulations, and in accordance with the utilization review
requirements pursuant to Section 6551 et seq. of Title 36 of the
Oklahoma Statutes and the review and deni al of substance use
disorder treatments an d services in Section 1250.5 et seq. of Title
36 of the Oklahoma Statutes .
SECTION 2. This act shall become effective Novem ber 1, 2023.
59-1-1923 RD 2/21/2023 11:57:41 AM