2019 -- H 5146

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LC000652

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

     

     Introduced By: Representatives Bennett, Edwards, McNamara, McEntee, and Jacquard

     Date Introduced: January 17, 2019

     Referred To: House Corporations

     It is enacted by the General Assembly as follows:

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     SECTION 1. Chapter 27-18 of the General Laws entitled "Accident and Sickness

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Insurance Policies" is hereby amended by adding thereto the following section:

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     27-18-27.1. Insurance coverage for annual pediatric mental health examinations.

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     (a) Every individual or group hospital or medical expense insurance policy, or individual

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or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

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this state on or after January 1, 2020, shall provide coverage for an annual pediatric mental health

7

examination when determined to be medically necessary and ordered by a physician or

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pediatrician and/or any court of this state having jurisdiction of children from the age of ten (10)

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years up to the age of eighteen (18) years.

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     (b) Benefit plans offered by an insurer may impose co-payment and/or deductibles for the

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benefits mandated by this chapter; however, in no instance shall the co-payment or deductible

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amount be greater than the co-payment or deductible amount imposed for physician office visits.

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Benefits for services under this section shall be reimbursed in accordance with the respective

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principles and mechanisms of reimbursement for each insurer, hospital, or medical service

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corporation, or health maintenance organization.

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     SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service

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Corporations" is hereby amended by adding thereto the following section:

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     27-19-18.1. Insurance coverage for annual pediatric mental health examinations.

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     (a) Every individual or group hospital or medical expense insurance policy, or individual

 

1

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

2

this state on or after January 1, 2020, shall provide coverage for an annual pediatric mental health

3

examination when determined to be medically necessary and ordered by a physician or

4

pediatrician and/or any court of this state having jurisdiction of children from the age of ten (10)

5

years up to the age of eighteen (18) years.

6

     (b) Benefit plans offered by an insurer may impose co-payment and/or deductibles for the

7

benefits mandated by this chapter; however, in no instance shall the co-payment or deductible

8

amount be greater than the co-payment or deductible amount imposed for physician office visits.

9

Benefits for services under this section shall be reimbursed in accordance with the respective

10

principles and mechanisms of reimbursement for each insurer, hospital, or medical service

11

corporation, or health maintenance organization.

12

     SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service

13

Corporations" is hereby amended by adding thereto the following section:

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     27-20-14.1. Insurance coverage for annual pediatric mental health examination.

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     (a) Every individual or group hospital or medical expense insurance policy, or individual

16

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

17

this state on or after January 1, 2020, shall provide coverage for an annual pediatric mental health

18

examination when determined to be medically necessary and ordered by a physician or

19

pediatrician and/or any court of this state having jurisdiction of children from the age of ten (10)

20

years up to the age of eighteen (18) years.

21

     (b) Benefit plans offered by an insurer may impose co-payment and/or deductibles for the

22

benefits mandated by this chapter; however, in no instance shall the co-payment or deductible

23

amount be greater than the co-payment or deductible amount imposed for physician office visits.

24

Benefits for services under this section shall be reimbursed in accordance with the respective

25

principles and mechanisms of reimbursement for each insurer, hospital, or medical service

26

corporation, or health maintenance organization.

27

     SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance

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Organizations" is hereby amended by adding thereto the following section:

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     27-41-61.1. Insurance coverage for annual pediatric mental health examination.

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     (a) Every individual or group hospital or medical expense insurance policy, or individual

31

or group hospital or medical services plan contract delivered, issued for delivery, or renewed in

32

this state on or after January 1, 2020, shall provide coverage for an annual pediatric mental health

33

examination when determined to be medically necessary and ordered by a physician or

34

pediatrician and/or any court of this state having jurisdiction of children from the age of ten (10)

 

LC000652 - Page 2 of 4

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years up to the age of eighteen (18) years.

2

     (b) Benefit plans offered by an insurer may impose co-payment and/or deductibles for the

3

benefits mandated by this chapter; however, in no instance shall the co-payment or deductible

4

amount be greater than the co-payment or deductible amount imposed for physician office visits.

5

Benefits for services under this section shall be reimbursed in accordance with the respective

6

principles and mechanisms of reimbursement for each insurer, hospital, or medical service

7

corporation, or health maintenance organization.

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     SECTION 5. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO INSURANCE -- ACCIDENT AND SICKNESS INSURANCE POLICIES

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     This act would require health insurance coverage for annual pediatric mental health

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examinations when determined to be medically necessary and ordered by a physician or

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pediatrician and/or any court order with jurisdiction of children from the age of ten (10) years up

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to age eighteen (18) years for polices issued on or after January 1, 2020.

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     This act would take effect upon passage.

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LC000652

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