2009 -- H 6087

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LC02348

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STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2009

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A N A C T

RELATING TO INSURANCE --INSURANCE COVERAGE FOR MENTAL ILLNESS AND

SUBSTANCE ABUSE

     Introduced By: Representative Peter N. Wasylyk

     Date Introduced: April 07, 2009

     Referred To: House Health, Education & Welfare

It is enacted by the General Assembly as follows:

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

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

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follows:

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

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have the following meanings:

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

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

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

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

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

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

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

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chapter does not apply to insurance coverage providing benefits for:

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      (i) Hospital confinement indemnity;

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      (ii) Disability income;

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      (iii) Accident only;

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      (iv) Long-term care;

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      (v) Medicare supplement;

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      (vi) Limited benefit health;

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      (vii) Specific disease indemnity;

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

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      (ix) Other limited benefit policies.

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

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

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

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

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

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including eating disorders as so defined therein; provided, that tobacco and caffeine are excluded

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from the definition of "substance" for the purposes of this chapter. "Mental illness" shall not

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include: (i) mental retardation, (ii) learning disorders, (iii) motor skills disorders, (iv)

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communication disorders, and (v) mental disorders classified as "V" codes. Nothing shall

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preclude persons with these conditions from receiving benefits provided under this chapter for

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any other diagnoses covered by this chapter.

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

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

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

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include methadone maintenance services or community residential care services for mental

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illnesses other than substance abuse disorders.

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

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illness and substance abuse.

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

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in accordance with chapter 24 of title 40.1.

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     SECTION 2. This act shall take effect upon passage.

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LC02348

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N A C T

RELATING TO INSURANCE --INSURANCE COVERAGE FOR MENTAL ILLNESS AND

SUBSTANCE ABUSE

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     This act would expand the definition of mental illness for insurance coverage to include

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eating disorders.

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     This act would take effect upon passage.

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LC02348

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