SB2095

Report Title:

Biologically-based Psychiatric and Addiction Disorders

Description:

Mandates coverage for biologically based psychiatric and addiction disorders by all health insurers, mutual benefit societies, and HMOs in the State after 12/31/2002.

THE SENATE	S.B. NO.	2095
TWENTY-FIRST LEGISLATURE, 2002
STATE OF HAWAII

A BILL FOR AN ACT

relating to mandatory health insurance.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that there is firm proof of the neurochemical basis for biologically based psychiatric and chemical addictive disorders. Support has been increasing for treating psychiatric and addictive disorders on a part with other medical disorders. While there is a perception that there is parity in Hawaii for mental illness and chemical dependency, these illnesses are not currently treated the same as other "physical" disorders. For example, visits for psychiatry and chemical dependency are limited in number while visits for other medical illness such as diabetes and hypertension are not.

The purpose of this Act is to ensure that medical treatment for biologically-based psychiatric and addictive disorders, to be provided by physicians with specialty training and who understand the interrelationship among the areas of anatomy, physiology, biochemistry, pathology, biology, genetics, neurology, medicine, and endocrinology, is given on the same basis to patients as medical treatment for other medical disorders, by mandating that all health insurance in the State cover these biologically-based psychiatric and addictive disorders.

SECTION 2. Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A to be appropriately designated and to read as follows:

"§431:10A- Biologically based psychiatric and addiction disorders; notice. (a) Any other law to the contrary notwithstanding, each employer group health policy, contract, plan, or agreement issued or renewed in this State after December 31, 2002, shall provide coverage to be provided by physicians with specialty training, not as an employer option, for biologically based psychiatric and addiction disorders to all policyholders and their dependents in this State.

(b) For the purposes of this section, "biologically based psychiatric and addiction disorder" means a disorder that is related to specific neurochemical abnormalities in the brain and is a brain based illness or disorder rather than an externally caused or situationally related disorder, although long-term exposure to stresses or short-term exposure to severe stresses can lead to some permanent brain disfunctions. In biologically based psychiatric and addiction disorders, the brain neurotransmitters involved in the disorder can be identified, and treatment intervention based on understanding of brain function can be planned. Biologically based psychiatric and addition disorders include:

(1) Affective disorders including:

(A) Major depressions; and

(B) Bipolar disorders;

(2) Thought disorders including:

(A) Schizophrenias;

(B) Schizoaffective disorders; and

(3) Anxiety disorders including:

(A) Generalized anxiety disorder;

(B) Post-traumatic stress disorder;

(D) Phobias;

(4) Chemical dependency disorders including:

(A) Drug addiction/dependence;

(B) Alcohol addiction/dependence; and

(c) Every insurer shall provide notice to its policyholders regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to policyholders and shall be transmitted to policyholders within calendar year 2002 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2002."

SECTION 3. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432- Biologically based psychiatric and addiction disorders; notice. (a) Any other law to the contrary notwithstanding, each individual and group hospital or medical service plan, policy, contract, or agreement issued or renewed in this State after December 31, 2002, shall provide coverage to be provided by physicians with specialty training, not as an employer option, for biologically based psychiatric and addiction disorders to all members and their dependents in this State.

(1) Affective disorders including:

(A) Major depressions; and

(B) Bipolar disorders;

(2) Thought disorders including:

(A) Schizophrenias;

(B) Schizoaffective disorders; and

(3) Anxiety disorders including:

(A) Generalized anxiety disorder;

(B) Post-traumatic stress disorder;

(D) Phobias;

(4) Chemical dependency disorders including:

(A) Drug addiction/dependence;

(B) Alcohol addiction/dependence; and

(c) Every mutual benefit society shall provide notice to its members regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to members and shall be transmitted to members within calendar year 2002 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2002."

SECTION 4. Chapter 432D, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"§432D- Biologically based psychiatric and addiction disorders; notice. (a) Any other law to the contrary notwithstanding, each health maintenance organization shall provide coverage to be provided by physicians with specialty training, not as an employer option, after December 31, 2002, for biologically based psychiatric and addiction disorders to all enrollees and their dependents in this State.

(1) Affective disorders including:

(A) Major depressions; and

(B) Bipolar disorders;

(2) Thought disorders including:

(A) Schizophrenias;

(B) Schizoaffective disorders; and

(3) Anxiety disorders including:

(A) Generalized anxiety disorder;

(B) Post-traumatic stress disorder;

(D) Phobias;

(4) Chemical dependency disorders including:

(A) Drug addiction/dependence;

(B) Alcohol addiction/dependence; and

(c) Every health maintenance organization shall provide notice to its enrollees regarding the coverage required by this section. The notice shall be in writing and prominently positioned in any literature or correspondence sent to enrollees and shall be transmitted to enrollees within calendar year 2002 when annual information is made available to enrollees, or in any other mailing to enrollees, but in no case later than December 31, 2002."

SECTION 5. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________