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Title 26 Insurance Code

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Change 1

What to do with it
As published

26-20-701. Required parity for mental health and substance use disorder insurance.

(a) All individual or group health insurance policies providing coverage on an expense incurred basis, individual and group service or indemnity type health insurance contracts issued by any insurer, including any nonprofit corporation and individual and group service contracts issued by a health maintenance organization, shall meet the requirements of, and the commissioner may enforce subject to the provisions of this section, the Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. § 300gg-26, as amended, and the regulations promulgated pursuant thereto as of January 1, 2018. Persons exempt from complying with the Mental Health Parity and Addiction Equity Act shall not be exempted from complying with the requirements of this section if this section otherwise applies to the person. The commissioner may promulgate reasonable rules which establish exemptions from the application of this section. (b) No policy or contract providing mental health or substance use coverage to which subsection (a) of this section applies shall: (i) Deny coverage for mental health or substance use services delivered using remote audio or audio-visual delivery systems to a person not physically present with the delivering health care provider if coverage would be provided for the same services when delivered in person; (ii) Charge a copayment, deductible or coinsurance amount to a person receiving mental health or substance use services through remote audio or audio-visual delivery systems that is higher than the copayment, deductible or coinsurance amount charged for the same services when delivered in person; (iii) Reduce any payment or reimbursement provided to a health care provider using remote audio or audio-visual delivery systems for the provision of mental health or substance use services to an amount that is less than the payment or reimbursement that would be made to a health care provider rendering those services in person.

Your change, as a redline

26-20-701. Required parity for mental health and substance use disorder insurance.

(a) All individual or group health insurance policies providing coverage on an expense incurred basis, individual and group service or indemnity type health insurance contracts issued by any insurer, including any nonprofit corporation and individual and group service contracts issued by a health maintenance organization, shall meet the requirements of, and the commissioner may enforce subject to the provisions of this section, the Mental Health Parity and Addiction Equity Act of 2008, 42 U.S.C. § 300gg-26, as amended, and the regulations promulgated pursuant thereto as of January 1, 2018. Persons exempt from complying with the Mental Health Parity and Addiction Equity Act shall not be exempted from complying with the requirements of this section if this section otherwise applies to the person. The commissioner may promulgate reasonable rules which establish exemptions from the application of this section. (b) No policy or contract providing mental health or substance use coverage to which subsection (a) of this section applies shall: (i) Deny coverage for mental health or substance use services delivered using remote audio or audio-visual delivery systems to a person not physically present with the delivering health care provider if coverage would be provided for the same services when delivered in person; (ii) Charge a copayment, deductible or coinsurance amount to a person receiving mental health or substance use services through remote audio or audio-visual delivery systems that is higher than the copayment, deductible or coinsurance amount charged for the same services when delivered in person; (iii) Reduce any payment or reimbursement provided to a health care provider using remote audio or audio-visual delivery systems for the provision of mental health or substance use services to an amount that is less than the payment or reimbursement that would be made to a health care provider rendering those services in person.

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