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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
SENATE BILL 444 By: Montgomery
AS INTRODUCED
An Act relating to mental health and substance use
disorder benefits; defining terms; requiring certain
health benefit plans provide reimbursement for
certain care pursuant to certain model; allowing for
denial of reimbursement 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 Statutes 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. “Health benefit plan” means a plan as defined pur suant to
Section 6060.4 of Title 36 of the Oklahoma Statutes;
2. “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
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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; and
3. “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.
The Insurance Commissioner shall keep current the list of
billing codes included in the Psychiatric Collaborative Care Model.
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 Psychiatric Collaborative
Care Model.
2. 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
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Equity Act of 2008 as amended and its implementing and related
regulations, and in accordance with the utilization review
requirements pursuant to Section 36-6551 et seq. of Title 36 of the
Oklahoma Statutes.
SECTION 2. This act shall become effective Novem ber 1, 2023.
59-1-790 RD 1/17/2023 9:39:38 AM