Rhode Island 2023 Regular Session

Rhode Island Senate Bill S0287 Compare Versions

Only one version of the bill is available at this time.

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5	5	2023 -- S 0287
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7	7	LC001195
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9	9	S TATE OF RHODE IS LAND
10	10	IN GENERAL ASSEMBLY
11	11	JANUARY SESSION, A.D. 2023
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14	14	A N A C T
15	15	RELATING TO INSURANCE -- INSURANCE COVERAGE FOR MENTAL ILLNESS AND
16	16	SUBSTANCE ABUSE
17	17	Introduced By: Senators Ujifusa, DiMario, Valverde, DiPalma, Lauria, Bell, Miller,
18	18	Acosta, Zurier, and Mack
19	19	Date Introduced: February 16, 2023
20	20	Referred To: Senate Health & Human Services
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23	23	It is enacted by the General Assembly as follows:
24	24	SECTION 1. Section 27-38.2-1 of the General Laws in Chapter 27-38.2 entitled "Insurance 1
25	25	Coverage for Mental Illness and Substance Abuse" is hereby amended to read as follows: 2
26	26	27-38.2-1. Coverage for treatment of mental health and substance use disorders. 3
27	27	(a) A group health plan and an individual or group health insurance plan shall provide 4
28	28	coverage for the treatment of mental health and/or substance use disorders under the same terms 5
29	29	and conditions as that coverage is provided for other illnesses and diseases. 6
30	30	(b) Coverage for the treatment of mental health and/or substance use disorders shall not 7
31	31	impose any annual or lifetime dollar limitation. 8
32	32	(c) Financial requirements and quantitative treatment limitations on coverage for the 9
33	33	treatment of mental health and/or substance use disorders shall be no more restrictive than the 10
34	34	predominant financial requirements applied to substantially all coverage for medical conditions in 11
35	35	each treatment classification. 12
36	36	(d) Coverage shall not impose non-quantitative treatment limitations for the treatment of 13
37	37	mental health and/or substance use disorders unless the processes, strategies, evidentiary standards, 14
38	38	or other factors used in applying the non-quantitative treatment limitation, as written and in 15
39	39	operation, are comparable to, and are applied no more stringently than, the processes, strategies, 16
40	40	evidentiary standards, or other factors used in applying the limitation with respect to 17
41	41	medical/surgical benefits in the classification. 18
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44	44	LC001195 - Page 2 of 3
45	45	(e) The following classifications shall be used to apply the coverage requirements of this 1
46	46	chapter: (1) Inpatient, in-network; (2) Inpatient, out-of-network; (3) Outpatient, in-network; (4) 2
47	47	Outpatient, out-of-network; (5) Emergency care; and (6) Crisis stabilization medications; and (7) 3
48	48	Prescription drugs. 4
49	49	(f) Medication-assisted treatment or medication-assisted maintenance services of substance 5
50	50	use disorders, opioid overdoses, and chronic addiction, including methadone, buprenorphine, 6
51	51	naltrexone, all federally-approved medications or other clinically appropriate medications, is 7
52	52	included within the appropriate classification based on the site of the service. 8
53	53	(g) Payors shall rely upon the criteria of the American Society of Addiction Medicine when 9
54	54	developing coverage for levels of care for substance use disorder treatment. 10
55	55	(h) Patients with substance use disorders shall have access to evidence-based, non-opioid 11
56	56	treatment for pain, therefore coverage shall apply to medically necessary chiropractic care and 12
57	57	osteopathic manipulative treatment performed by an individual licensed under § 5-37-2. 13
58	58	(i) Parity of cost-sharing requirements. Regardless of the professional license of the 14
59	59	provider of care, if that care is consistent with the provider’s scope of practice and the health plan’s 15
60	60	credentialing and contracting provisions, cost-sharing for behavioral health counseling visits and 16
61	61	medication maintenance visits shall be consistent with the cost-sharing applied to primary care 17
62	62	office visits. 18
63	63	(j) The coverage required by this section shall include at minimum ninety (90) days of 19
64	64	residential or inpatient services for mental health and/or substance use disorders for American 20
65	65	Society of Addiction Medicine levels of care 3.1 and 3.3. 21
66	66	SECTION 2. This act shall take effect on April 1, 2024. 22
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68	68	LC001195
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72	72	LC001195 - Page 3 of 3
73	73	EXPLANATION
74	74	BY THE LEGISLATIVE COUNCIL
75	75	OF
76	76	A N A C T
77	77	RELATING TO INSURANCE -- INSURANCE COVERAGE F OR MENTAL ILLNESS AND
78	78	SUBSTANCE ABUSE
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80	80	This act would require insurance coverage for at minimum ninety (90) days of residential 1
81	81	or inpatient services for mental health and/or substance use disorders for American Society of 2
82	82	Addiction Medicine levels of care 3.1 and 3.3. 3
83	83	This act would take effect on April 1, 2024. 4
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85	85	LC001195
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