Chapter 262

2006 -- S 2706 SUBSTITUTE A AS AMENDED

Enacted 07/03/06

 

A N  A C T

RELATING TO HEALTH AND SAFETY

          

     Introduced By: Senators Perry, Goodwin, Roberts, C Levesque, and Walaska

     Date Introduced: February 14, 2006

 

It is enacted by the General Assembly as follows:

 

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

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

 

     27-18-66. Tobacco cessation programs. – (1) Every individual or group health

insurance contract, plan or policy delivered, issued for delivery or renewed in this state on or after

January 1, 2007, which provides medical coverage that includes coverage for physician services

in a physician's office, and every policy which provides major medical or similar comprehensive-

type coverage, shall include coverage for smoking cessation treatment, provided that if such

medical coverage does not include prescription drug coverage, such contract, plan or policy shall

not be required to include coverage for prescription nicotine replacement therapy.

     (2) As used in this section, smoking cessation treatment includes the use of an over-the-

counter (OTC) or prescription US Food and Drug Administration (FDA) approved nicotine

replacement therapy, when recommended and prescribed by a prescriber who holds prescriptive

privileges in the state in which they are licensed, and used in combination with an annual

outpatient benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions provided

by a qualified practitioner for each covered individual. Smoking cessation treatment may be

further defined through regulation promulgated by the health insurance commissioner.

     (3) Health insurance contracts, plans, or policies to which this section applies, may

impose copayments and/or deductibles for the benefits mandated by this section consistent with

the contracts', plans' or policies' copayments and/or deductibles for physician services and

medications. Nothing contained in this section shall impact the reimbursement, medical necessity

or utilization review, managed care, or case management practices of these health insurance

contracts, plans or policies.

     (4) This section shall not apply to insurance coverage providing benefits for:

     (a) hospital confinement indemnity;

     (b) disability income;

     (c) accident only;

     (d) long-term care;

     (e) Medicare supplement;

     (f) limited benefit health;

     (g) specified disease indemnity;

     (h) sickness or bodily injury or death by accident or both; and

(i)   other limited benefit policies.

 

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

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

 

     27-19-57. Tobacco cessation programs. -- (1) Every individual or group health

insurance contract, plan or policy delivered, issued for delivery or renewed in this state on or after

January 1, 2007, which provides medical coverage that includes coverage for physician services

in a physician's office, and every policy which provides major medical or similar comprehensive-

type coverage, shall include coverage for smoking cessation treatment, provided that if such

medical coverage does not include prescription drug coverage, such contract, plan or policy shall

not be required to include coverage for prescription nicotine replacement therapy.

     (2) As used in this section, smoking cessation treatment includes the use of an over-the-

counter (OTC) or prescription US Food and Drug Administration (FDA) approved nicotine

replacement therapy, when recommended and prescribed by a prescriber who holds prescriptive

privileges in the state in which they are licensed, and used in combination with an annual

outpatient benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions provided

by a qualified practitioner for each covered individual. Smoking cessation treatment may be

further defined through regulation promulgated by the health insurance commissioner.

     (3) Health insurance contracts, plans, or policies to which this section applies, may

impose copayments and/or deductibles for the benefits mandated by this section consistent with

the contracts', plans' or policies' copayments and/or deductibles for physician services and

medications. Nothing contained in this section shall impact the reimbursement, medical necessity

or utilization review, managed care, or case management practices of these health insurance

contracts, plans or policies.

     (4) This section shall not apply to insurance coverage providing benefits for:

     (a) hospital confinement indemnity;

     (b) disability income;

     (c) accident only;

     (d) long-term care;

     (e) Medicare supplement;

     (f) limited benefit health;

     (g) specified disease indemnity;

     (h) sickness or bodily injury or death by accident or both; and

     (i) other limited benefit policies.

 

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

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

 

     27-20-53. Tobacco cessation programs. -- (1) Every individual or group health

insurance contract, plan or policy delivered, issued for delivery or renewed in this state on or after

January 1, 2007, which provides medical coverage that includes coverage for physician services

in a physician's office, and every policy which provides major medical or similar comprehensive-

type coverage, shall include coverage for smoking cessation treatment, provided that if such

medical coverage does not include prescription drug coverage, such contract, plan or policy shall

not be required to include coverage for prescription nicotine replacement therapy.

     (2) As used in this section, smoking cessation treatment includes the use of an over-the-

counter (OTC) or prescription US Food and Drug Administration (FDA) approved nicotine

replacement therapy, when recommended and prescribed by a prescriber who holds prescriptive

privileges in the state in which they are licensed, and used in combination with an annual

outpatient benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions provided

by a qualified practitioner for each covered individual. Smoking cessation treatment may be

further defined through regulation promulgated by the health insurance commissioner.

     (3) Health insurance contracts, plans, or policies to which this section applies, may

impose copayments and/or deductibles for the benefits mandated by this section consistent with

the contracts', plans' or policies' copayments and/or deductibles for physician services and

medications. Nothing contained in this section shall impact the reimbursement, medical necessity

or utilization review, managed care, or case management practices of these health insurance

contracts, plans or policies.

     (4) This section shall not apply to insurance coverage providing benefits for:

     (a) hospital confinement indemnity;

     (b) disability income;

     (c) accident only;

     (d) long-term care;

     (e) Medicare supplement;

     (f) limited benefit health;

     (g) specified disease indemnity;

     (h) sickness or bodily injury or death by accident or both; and

     (i)  other limited benefit policies.

 

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

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

 

     27-41-70. Tobacco cessation programs. -- (1) Every individual or group health

insurance contract, plan or policy delivered, issued for delivery or renewed in this state on or after

January 1, 2007, which provides medical coverage that includes coverage for physician services

in a physician's office, and every policy which provides major medical or similar comprehensive-

type coverage, shall include coverage for smoking cessation treatment, provided that if such

medical coverage does not include prescription drug coverage, such contract, plan or policy shall

not be required to include coverage for prescription nicotine replacement therapy.

     (2) As used in this section, smoking cessation treatment includes the use of an over-the-

counter (OTC) or prescription US Food and Drug Administration (FDA) approved nicotine

replacement therapy, when recommended and prescribed by a prescriber who holds prescriptive

privileges in the state in which they are licensed, and used in combination with an annual

outpatient benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions provided

by a qualified practitioner for each covered individual. Smoking cessation treatment may be

further defined through regulation promulgated by the health insurance commissioner.

     (3) Health insurance contracts, plans, or policies to which this section applies, may

impose copayments and/or deductibles for the benefits mandated by this section consistent with

the contracts', plans' or policies' copayments and/or deductibles for physician services and

medications. Nothing contained in this section shall impact the reimbursement, medical necessity

or utilization review, managed care, or case management practices of these health insurance

contracts, plans or policies.

     (4) This section shall not apply to insurance coverage providing benefits for:

     (a) hospital confinement indemnity;

     (b) disability income;

     (c) accident only;

     (d) long-term care;

     (e) Medicare supplement;

     (f) limited benefit health;

     (g) specified disease indemnity;

     (h) sickness or bodily injury or death by accident or both; and

(i)  other limited benefit policies.

 

     SECTION 5. This act shall take effect upon passage.

     

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LC02402/SUB A/2

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