2014 -- H 7979

========

LC004941

========

     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2014

____________

A N   A C T

RELATING TO INSURANCE - MEDICAL - INSURANCE COVERAGE FOR MENTAL

ILLNESS AND SUBSTANCE ABUSE

     Introduced By: Representatives Naughton, McNamara, Ferri, Shekarchi, and Martin

     Date Introduced: March 26, 2014

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 27-38.2-2 of the General Laws in Chapter 27-38.2 entitled

"Insurance Coverage for Mental Illness and Substance Abuse" is hereby amended to read as

follows:

     27-38.2-2. Definitions. -- For the purposes of this chapter, the following words and terms

have the following meanings:

      (1) "Health insurers" means all persons, firms, corporations, or other organizations

offering and assuring health services on a prepaid or primarily expense-incurred basis, including

but not limited to policies of accident or sickness insurance, as defined by chapter 18 of this title,

nonprofit hospital or medical service plans, whether organized under chapter 19 or 20 of this title

or under any public law or by special act of the general assembly, health maintenance

organizations, or any other entity which insures or reimburses for diagnostic, therapeutic, or

preventive services to a determined population on the basis of a periodic premium. Provided, this

chapter does not apply to insurance coverage providing benefits for:

      (i) Hospital confinement indemnity;

      (ii) Disability income;

      (iii) Accident only;

      (iv) Long-term care;

      (v) Medicare supplement;

      (vi) Limited benefit health;

      (vii) Specific disease indemnity;

      (viii) Sickness or bodily injury or death by accident or both; and

      (ix) Other limited benefit policies.

      (2) "Mental illness" means any mental disorder and substance abuse disorder that is

listed in the most recent revised publication or the most updated volume of either the Diagnostic

and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric

Association or the International Classification of Disease Manual (ICO) published by the World

Health Organization and that substantially limits the life activities of the person with the illness;

provided, that tobacco and caffeine are excluded from the definition of "substance" for the

purposes of this chapter. "Mental illness" shall not include: (i) mental retardation, (ii) learning

disorders, (iii) motor skills disorders, (iv) communication disorders, and (v) mental disorders

classified as "V" codes. Nothing shall preclude persons with these conditions from receiving

benefits provided under this chapter for any other diagnoses covered by this chapter.

      (3) "Mental illness coverage" means inpatient hospitalization, partial hospitalization

provided in a hospital or any other licensed facility, intensive out patient services, outpatient

services and community residential care services for substance abuse treatment. It shall not

include methadone maintenance services or community residential care services for mental

illnesses other than substance abuse disorders.

      (4) "Outpatient services" means office visits that provide for the treatment of mental

illness and substance abuse.

      (5) "Community residential care services" mean those facilities as defined and licensed

in accordance with chapter 24 of title 40.1.

     SECTION 2. This act shall take effect upon passage.

========

LC004941

========

LC004941 - Page 2 of 3

EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE - MEDICAL - INSURANCE COVERAGE FOR MENTAL

ILLNESS AND SUBSTANCE ABUSE

***

     This act would remove "methadone maintenance services" from the definition of mental

illness coverage for medical insurance purposes.

     This act would take effect upon passage.

========

LC004941

========

LC004941 - Page 3 of 3