Introduced By: Representatives Hetherington, Dennigan, Ajello, Benoit and Costantino
Date Introduced : February 3, 1998
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:
{ADD 27-18-51. Restricted annual rate payments prohibited. -- ADD} {ADD No policy delivered or issued in this state shall contain a provision for compensating any provider of outpatient mental health and/or substance abuse treatment service by using the restricted annual rate method of payment. ADD}
{ADD The restricted annual rate method of payment is defined as any method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per person per unit of time criteria that disregards the extent of treatment and/or degree of services rendered. ADD}
{ADD This prohibition shall not be construed to prohibit or limit capitation or other risk sharing agreements between providers and insurers otherwise permissible by law. ADD}
SECTION 2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service Corporations" is hereby amended by adding thereto the following section:
{ADD 27-19-43. Restricted annual rate payments prohibited. -- ADD} {ADD No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. ADD}
{ADD The restricted annual rate method of payment is defined as any method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per person per unit of time criteria that disregards the extent of treatment and/or degree of services rendered. ADD}
{ADD This prohibition shall not be construed to prohibit or limit capitation or other risk sharing agreements between providers and insurers otherwise permissible by law. ADD}
SECTION 3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service Corporations" is hereby amended by adding thereto the following section:
{ADD 27-20-38. Restricted annual rate payments prohibited. -- ADD} {ADD No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. ADD}
{ADD The restricted annual rate method of payment is defined as any method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per person per unit of time criteria that disregards the extent of treatment and/or degree of services rendered. ADD}
{ADD This prohibition shall not be construed to prohibit or limit capitation or other risk sharing agreements between providers and insurers otherwise permissible by law. ADD}
SECTION 4. Chapter 27-41 of the General Laws entitled "Health Maintenance Organizations" is hereby amended by adding thereto the following section:
{ADD 27-41-52. Restricted annual rate payments prohibited. -- ADD} {ADD No corporation organized under this chapter shall compensate any provider of outpatient service by using the restricted annual rate method of payment. ADD}
{ADD The restricted annual rate method of payment is defined as any method of payment that sets, as all or part of its payment scheme, a total payment limit for mental health and/or substance abuse treatment services for each person seeking treatment based on a per person per unit of time criteria that disregards the extent of treatment and/or degree of services rendered. ADD}
{ADD This prohibition shall not be construed to prohibit or limit capitation or other risk sharing agreements between providers and insurers otherwise permissible by law. ADD}
SECTION 5. This act shall take effect upon passage.
