Mental Health care Access-Collaborative Care Model.

Plain English Breakdown

Checked against official source text during the last sync.

Mental Health Care Access - Collaborative Care Model

This law requires health insurance policies to cover mental health and substance use disorder benefits delivered through a collaborative care model, starting July 1, 2023.

What This Bill Does

• Requires health insurance policies that offer mental health and substance use disorder benefits to pay for services provided by the Psychiatric Collaborative Care Model.
• Defines 'mental health and substance use disorder benefits' as treatments listed in medical manuals like the International Classification of Disease or Diagnostic and Statistical Manual of Mental Disorders.
• Exempts any policy, contract, or service that would require state funding from this requirement.
• Allows insurers to apply appropriate medical management for services rendered under the collaborative care model.
• Requires the Department of Insurance Commissioner to create rules for implementing these requirements by July 1, 2023.

Who It Names or Affects

• People with health insurance policies that cover mental health and substance use disorder benefits.
• Health insurers who must provide reimbursement for services under the collaborative care model starting July 1, 2023.

Terms To Know

Psychiatric Collaborative Care Model

A patient-centered approach to psychiatric treatment involving a primary care provider, a care manager, and a psychiatric consultant.

Medical Management

The process used by health insurers to ensure that medical services are appropriate and necessary for the patient's condition.

Limits and Unknowns

• Does not apply to policies or plans issued before July 1, 2023.
• Exempts any policy requiring state funding from this requirement.

Official Summary Text

Bill Summary - 23LSO-0348
Bill No.:

HB0140

Effective:

Multiple Dates

LSO No.:

23LSO-0348

Enrolled Act No.:

HEA No. 0068

Chapter No.:

132

Prime Sponsor:

Zwonitzer, Dn

Catch Title:

Mental Health care Access-Collaborative Care Model.

Subject:

Mental health benefits - reimbursement.

Summary/Major Elements:

The Psychiatric Collaborative Care Model is a patient-centered approach to psychiatric treatment that involves a primary care provider, a care manager and a psychiatric consultant.

This bill requires specified health insurance policies that provide mental health and substance use disorder benefits to provide reimbursement for benefits that are delivered to the insured through the Psychiatric Collaborative Care Model.

The bill provides exceptions for any policy, contract or service that would require the state to defray the cost as specified and clarifies that the bill does not restrict the health insurer's ability to apply appropriate medical management for the services rendered.

The bill requires the Commissioner of the Department of Insurance to promulgate any rules necessary and specifies that the bill only applies to plans that are delivered, issued, renewed, modified, amended or extended on or after July 1, 2023.

The above summary is not an official publication of the Wyoming Legislature and is not an official statement of legislative intent.

While the Legislative Service Office endeavored to provide accurate information in this summary, it should not be relied upon as a comprehensive abstract of the bill.

Current Bill Text

23LSO-0348

ORIGINAL House

Bill No
.
HB0140

ENROLLED ACT NO. 68,

HOUSE OF REPRESENTATIVES

SIXTY-SEVENTH LEGISLATURE OF THE STATE OF WYOMING
2023 General Session

AN ACT relating to health insurance; specifying reimbursement requirements for mental health and substance use disorder benefits as specified; providing definitions; requiring rulemaking; specifying applicability; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1
.

W.S. 26
‑
20
‑
702 is created to read:

26
‑
20
‑
702.

Reimbursement for mental health and substance use disorder benefits.

(a)

As used in this section "mental health and substance use disorder benefits" means benefits for the treatment of any condition or disorder that involves a mental health condition or substance use disorder that falls under any of the diagnostic categories listed in the mental disorders section of the most recent edition of the International Classification of Disease or that is listed in the mental disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental Disorders.

(b)

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 and individual and group service contracts that provide mental health and substance use disorder benefits shall provide reimbursement for

benefits that are delivered through the psychiatric Collaborative Care Model as defined by the American Medical Association's most recent procedural terminology codes and where a licensed and credentialed primary care team consists of a primary care provider, a care manager and a psychiatric consultant.

(c)

The benefit and reimbursement requirements of subsection (b) of this section shall not apply to any policy, contract or service that would require the state to defray the cost as specified in 42 U.S.C. 18031(d)(3)(B)(ii).

(d)

Nothing in this section shall restrict the health insurer's ability to apply appropriate medical management for the services rendered.

Section 2.

The commissioner shall promulgate any rules necessary to implement this act not later than July 1, 2023.

Section 3.

This act shall only apply to any individual or group health insurance policies providing coverage on an expense incurred basis, individual and group service or indemnity type health insurance contracts and individual and group service contracts that provide mental health and substance use disorder benefits policies or plans that are delivered, issued, renewed, modified, amended or extended on or after July 1, 2023.

Section 4
.

(a)

Except as provided in subsection (b) of this section this act is effective July 1, 2023
.

(b)

Sections 2 and 4 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the House.

Chief Clerk

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