OK
Oklahoma Senate Bill SB444

Oklahoma 2023 Regular Session

Oklahoma Senate Bill SB444 Compare Versions

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28+ENGROSSED HOUSE AMENDME NT
29+ TO
30+ENGROSSED SENATE BILL NO . 444 By: Montgomery of the Senate
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34+ Miller of the House
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5-An Act
6-ENROLLED SENATE
7-BILL NO. 444 By: Montgomery of the Senate
8-
9- and
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11- Miller and Provenzano of
12-the House
39+[ mental health and substance use disorder benefits -
40+reimbursement - necessity determination -
41+codification - effective date ]
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16-An Act relating to ment al health and substance abuse
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48+AUTHOR: Add the following House Coauthor: Provenzano
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50+AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
51+and insert:
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53+
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56+"An Act relating to ment al health and substance abuse
1757 disorder benefits; defining terms; requiring certain
1858 health benefit plans and Oklahoma Medicaid Program to
1959 provide reimbursement for c ertain care pursuant to
2060 certain models; allowing for denial of reimburs ement
2161 under certain circumstances; providing for necessity
2262 determination; providing for codification; and
2363 providing an effective date.
2464
2565
2666
27-SUBJECT: Health benefits
2867
2968 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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3169 SECTION 1. NEW LAW A new sectio n of law to be codified
3270 in the Oklahoma Statutes as Section 6060.11a of Title 36, unless
3371 there is created a duplication in numbering, reads as follows:
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3598 A. For the purposes of this section:
36-
3799 1. “Behavioral health integration” means an approach to
38100 delivering mental health care that improves the ability for primary
39101 care providers to include mental and behavioral health screening,
40102 treatment, and specialty care i nto their practice pursuant to
41103 Current Procedural Terminology billing code 99484, as established by
42104 the American Medical Association;
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44105 2. “Health benefit plan” means a plan as defined pur suant to
45106 Section 6060.4 of Title 36 of the Oklahoma Statutes;
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48-ENR. S. B. NO. 444 Page 2
49107 3. “Mental health and substance abuse disorder benefits” means
50108 benefits for the treatment of any condition or disorder that
51109 involves a mental health condition or substance abuse disorder ,
52110 including, but not limited to, those that fall under any of the
53111 diagnostic categories listed in the mental disorders section of the
54112 most recent edition of the International C lassification of Diseases
55113 or in the mental disorders section of the most recent version of the
56114 Diagnostic and Statistical Manual of Mental Disorders;
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58115 4. “Oklahoma Medicaid Program” means the state program
59116 administered by the Oklahoma Health Care Authority pursuant to
60117 Section 1002 of Title 56 of the Oklahoma Statutes; and
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62118 5. “Psychiatric collaborative care model” means the evidence-
63119 based, integrated behavioral he alth service delivery method
64120 described pursuant to 81 C.F.R. 80230. The model shall include, b ut
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65147 not be limited to, the following Current Procedural Terminology
66148 billing codes, as established by the Amer ican Medical Association:
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68149 a. 99492,
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70150 b. 99493, and
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72151 c. 99494.
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74152 B. 1. Any health benefit plan that is offered, issued, or
75153 renewed in this state and th at provides mental health or substance
76154 abuse disorder benefits shall provide reimbursement for such
77155 benefits that are delivered through the behavioral health
78156 integration and psychiatric collaborative care models.
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80157 2. The Oklahoma Medicaid Program shall pro vide reimbursement
81158 for such benefits that are delivered through the behavioral health
82159 integration and psychiatric collaborative care models.
83-
84160 3. Plans offered, issued, or renewed in this state that provide
85161 benefits under this subsection may deny reimbursement of any Current
86162 Procedural Terminology code pursuant to paragraph 3 of subsection A
87163 of this section due to medical necessity; provided, such medical
88164 necessity determinations shall be in compliance with the federal
89165 Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
90166 Equity Act of 2008, as amended, and its implementing and related
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92-ENR. S. B. NO. 444 Page 3
93167 regulations, and in accordance with the utilization review
94168 requirements pursuant to Section 6551 et seq. of Title 36 of the
95169 Oklahoma Statutes and the review and d enial of mental health and
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96196 substance abuse disorder treatments an d services in Section 1250.5
97197 et seq. of Title 36 of the Oklahoma Statutes.
98-
99-SECTION 2. This act shall become effective November 1, 2023.
198+SECTION 2. This act shall become effective November 1, 2023."
199+Passed the House of Representatives the 26th day of April, 2023.
100200
101201
102-ENR. S. B. NO. 444 Page 4
103-Passed the Senate the 24th day of May, 2023.
202+
203+
204+
205+Presiding Officer of the House of
206+ Representatives
207+
208+
209+Passed the Senate the ____ day of __________, 2023.
210+
211+
104212
105213
106214
107215 Presiding Officer of the Senate
108216
109217
110-Passed the House of Representatives the 26th day of April, 2023.
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243+ENGROSSED SENATE
244+BILL NO. 444 By: Montgomery of the Senate
245+
246+ and
247+
248+ Miller of the House
249+
250+
251+
252+
253+[ mental health and substance use disorder benefits -
254+reimbursement - necessity determination -
255+codification - effective date ]
256+
257+
258+
259+
260+
261+BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
262+SECTION 3. NEW LAW A new section of law to be codified
263+in the Oklahoma Statu tes as Section 6060.11a of Title 36, unless
264+there is created a duplication in numbering, reads as follows:
265+A. For the purposes of this section:
266+1. “Behavioral health integration” means an approach to
267+delivering mental health care that improves the ability for primary
268+care providers to include mental and behavioral health screening,
269+treatment, and specialty care i nto their practice pursuant to
270+current procedural terminology billing code 99484, as established by
271+the American Medical Association ;
272+2. “Health benefit plan” means a plan as defined pur suant to
273+Section 6060.4 of Title 36 of the Oklahoma Statutes;
274+3. “Mental health and substance abuse disorder benefits” means
275+benefits for the treatment of any condition or disord er that
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302+involves a mental health condition or substance abuse disorder ,
303+including but not limited to those that fall under any of the
304+diagnostic categories listed in the mental disorders section of the
305+most recent edition of the International Classificatio n of Diseases
306+or in the mental disorders section of the most recent version of the
307+Diagnostic and Statistical Manual of Mental Disorders;
308+4. “Oklahoma Medicaid Program” means the state program
309+administered by the Oklahoma Health Care Authority pursuant to
310+Section 1002 of Title 56 of the Oklahoma Statutes; and
311+5. “Psychiatric collaborative care model” means the evidence-
312+based, integrated behavioral he alth service delivery method
313+described pursuant to 81 C.F.R. 80230. The model shall include, but
314+not be limited to, the following current procedural terminology
315+billing codes, as established by the Amer ican Medical Association:
316+a. 99492,
317+b. 99493, and
318+c. 99494.
319+B. 1. Any health benefit plan that is offered, issued, or
320+renewed in this state and tha t provides mental health or substance
321+abuse disorder benefits shall provide reimbursement for such
322+benefits that are delivered through the behavioral health
323+integration and psychiatric collaborative care models.
324+
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350+2. The Oklahoma Medicaid Program shall provide re imbursement
351+for such benefits that are delivered through the behavioral health
352+integration and psychiatric collaborative care models.
353+3. Plans offered, issued, or renewed in this state that provide
354+benefits under this subsection may deny reimbursement of any current
355+procedural terminology code pursuant to paragraph 3 of subsection A
356+of this section due to medical necessity; provided, such medical
357+necessity determinations shall be in compliance with the federal
358+Paul Wellstone and Pete Domenici Mental Health Parity and Addiction
359+Equity Act of 2008, as amended, and its implementing and related
360+regulations, and in accordance with the utilization review
361+requirements pursuant to Section 6551 et seq. of Title 36 of the
362+Oklahoma Statutes and the review and deni al of substance use
363+disorder treatments an d services in Section 1250.5 et seq. of Title
364+36 of the Oklahoma Statutes.
365+SECTION 4. This act shall become effective November 1, 2023.
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392+Passed the Senate the 8th day of March, 2023.
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396+ Presiding Officer of the Senate
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399+Passed the House of Representatives the ____ day of __________,
400+2023.
111401
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114404 Presiding Officer of the House
115405 of Representatives
116406
117-OFFICE OF THE GOVERNOR
118-Received by the Office of the Governor this _______ _____________
119-day of _________________ __, 20_______, at _______ o'clock _______ M.
120-By: _______________________________ __
121-Approved by the Governor of the State of Oklahoma this _____ ____
122-day of _________________ __, 20_______, at _______ o'clock _______ M.
123407
124- _________________________________
125- Governor of the State of Oklahoma
126-
127-
128-OFFICE OF THE SECRETARY OF STATE
129-Received by the Office of the Secretary of State this _______ ___
130-day of __________________, 20 _______, at _______ o'clock _______ M.
131-By: _______________________________ __