Behavioral health redesign amendments-2.

Plain English Breakdown

The candidate explanation includes a statement about requiring behavioral health service providers to bill private insurance before billing the state, which is implied by the requirement for third party liability measures but not directly stated in the official text.

Behavioral Health Redesign Amendments

This law changes how the Department of Health pays for behavioral health services and requires reports on these payments.

What This Bill Does

• Requires behavioral health service providers to bill private insurance before billing the state.
• Changes who can be considered 'indigent general access clients' by adding a requirement that they do not have private or public health insurance covering mental illness or substance use disorder treatment after June 30, 2026.
• Requires the Department of Health to collect information on behavioral health claims and report this data to an interim committee.

Who It Names or Affects

• Behavioral health service providers
• The Department of Health
• People who receive behavioral health services

Terms To Know

Indigent general access clients

Individuals without private or public health insurance covering mental illness or substance use disorder treatment, and whose income is below two hundred percent of the federal poverty level.

Limits and Unknowns

• The law does not specify how the Department of Health will implement changes to third party liability measures.
• It's unclear what recommendations the interim committee might make based on the report from the Department of Health.

Official Summary Text

Bill Summary - 24LSO-0593

Bill No.:

SF0115

Effective:

7/1/2024

LSO No.:

24LSO-0593

Enrolled Act No.:

SEA No. 0019

Chapter No.:

35

Prime Sponsor:

Baldwin

Catch Title:

Behavioral health redesign amendments-2.

Has Report:

Yes

Subject:

Changes to how the Department of Health will pay behavioral health claims.

Summary/Major Elements:

Specifies how the Department of Health will pay behavioral health claims by requiring behavioral health service providers to bill private health insurance and other liable third parties before the provider submits a claim to the Department.

Amends the definition of "indigent general access clients" and provides a sunset date of June 30, 2026 for any person who has private or public health insurance that provides coverage for mental illness or substance use disorder treatment to be qualified as an indigent general access client.

Comments:

This act amends the Community Human Services Act.

This act requires the Department
to collect information regarding payment of behavioral health claims and requires the Department to report that information to the Joint Labor, Health and Social Services Interim Committee.

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

24LSO-0593

ORIGINAL Senate

File No
.
SF0115

ENROLLED ACT NO. 19,

SENATE

SIXTY-SEVENTH LEGISLATURE OF THE STATE OF WYOMING
2024 Budget Session

AN ACT relating to public health and safety; requiring the department of health to pay behavioral health services claims as specified; requiring the department of health to collect information regarding payment of behavioral health services claims; requiring a report; amending definitions; providing a sunset date; and providing for an effective date.

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

Section 1
.

W.S. 35
‑
1
‑
613(a)(xix), as amended by 2021 Wyoming Session Laws, Chapter 79, Section 1 and as amended by 2022 Wyoming Session Laws, Chapter 31, Section 1, is amended to read:

35
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1
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613.

Definitions.

(a)

As used in this act:

(xix)

"Indigent general access clients" means persons
who do not have private or public health insurance that provides coverage for mental illness or substance use disorder treatment and
whose total household income is not more than two hundred percent (200%) of the federal poverty level
.

After July 1, 2026 a person who has private or public health insurance that provides coverage for mental illness or substance use disorder treatment shall not qualify as "indigent general access clients"
;

Section 2.

If a behavioral health center sends the department of health a claim for behavioral health services, the department shall pay the claim in the same manner as it would have prior to the behavioral health redesign, recognizing that providers have been and will continue to be obligated contractually to bill private health insurance and other liable third parties before submitting claims to the state. The department shall utilize its claims processing system and data warehouse infrastructure to collect information on the potential magnitude of savings from implementing additional third party liability measures and shall report these findings to substantiate a recommendation on the design of a new third party liability system to the joint labor, health and social services interim committee not later than September 1, 2025.

Section 3
.

This act is effective July 1, 2024
.

(END)

Speaker of the House

President of the Senate

Governor

TIME APPROVED: _________

DATE APPROVED: _________

I hereby certify that this act originated in the Senate.

Chief Clerk

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