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THE SENATE |
S.B. NO. |
2608 |
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THIRTY-THIRD LEGISLATURE, 2026 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
relating to Insurance.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:
"§431:10A-
Annual mental health wellness examination coverage. (a) Each individual and group policy of accident
and health or sickness insurance issued or renewed in the State after December
31, 2026, except for policies that only provide coverage for a specified
disease or other limited benefit coverage as described in section 431:10A-607, shall provide coverage for an annual mental health
wellness examination; provided that each covered annual
mental health wellness examination:
(1) Shall be:
(A) Up
to sixty minutes in duration;
(B) Performed
by a qualified mental health care provider; and
(C) Exempt
from any deductible or copayment provisions that may be in force in an
applicable policy or contract; and
(2) May
include:
(A) Observation;
(B) A
behavioral health screening;
(C) Education
and consultation on healthy lifestyle changes;
(D) Referrals
for ongoing treatment, mental health services, and other necessary supports;
(E) Discussion
of potential options for medication;
(F) Age-appropriate
screenings or observations to understand a covered person's mental health
history, personal history, and mental or cognitive state; and
(G) If appropriate, relevant adult input
through screenings, interviews, and questions.
(b) The coverage required by this section shall:
(1) Be
at least as extensive as coverage for a physical examination; and
(2) Comply
with the rules and requirements of the Mental Health Parity and Addiction
Equity Act of 2008.
(c) Each accident and health or
sickness insurer shall reimburse any qualified mental
health care provider complying with this section for all costs associated with
the coverage required by this section.
(d) For the purposes of this section:
"Mental health wellness examination" means
an examination to identify a covered person's behavioral or mental health needs
and any appropriate resources for treatment.
"Qualified
mental health care provider" includes:
(1) A physician licensed pursuant to
chapter 453, who is board certified in psychiatry or another mental or
behavioral health care area;
(2) A physician assistant licensed
pursuant to chapter 453, who is trained in psychiatry or mental health;
(3) A psychologist licensed pursuant to
chapter 465;
(4) A clinical social worker licensed
pursuant to chapter 467E;
(5) A marriage and family therapist
licensed pursuant to chapter 451J;
(6) A mental health counselor licensed
pursuant to chapter 453D;
(7) A substance abuse counselor
certified pursuant to section 321-193(10); or
(8) An advanced practice registered
nurse licensed pursuant to chapter 457, who holds an accredited national
certification in an advanced practice registered nurse psychiatric
specialization."
SECTION 2. Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article I to be appropriately designated and to read as follows:
"§432:1-
Annual mental health wellness examination coverage. (a) Each individual or group
hospital or medical service plan contract issued or renewed in this State after
December 31, 2026, shall provide coverage for an annual mental health wellness
examination; provided that each covered annual mental health wellness examination:
(1) Shall
be:
(A) Up to sixty minutes in duration;
(B) Performed by a qualified mental
health care provider; and
(C) Exempt from any deductible or
copayment provisions that may be in force in any contract; and
(2) May include:
(A) Observation;
(B) A behavioral health screening;
(C) Education and consultation on
healthy lifestyle changes;
(D) Referrals for ongoing treatment,
mental health services, and other necessary supports;
(E) Discussion of potential options for
medication;
(F) Age-appropriate screenings or
observations to understand a covered person's mental health history, personal
history, and mental or cognitive state; and
(G) If appropriate, relevant adult input through screenings,
interviews, and questions.
(b)
The coverage required by this section shall:
(1) Be at least as extensive as coverage
for a physical examination; and
(2) Comply with the rules and requirements
of the Mental Health Parity and Addiction Equity Act of 2008.
(c) Each mutual benefit society
shall reimburse any qualified mental health care provider complying with this
section for all costs associated with the coverage required by this section.
(d) For the purposes of this
section:
"Mental health wellness examination" means an examination to identify a covered person's behavioral or mental health needs and any appropriate resources for treatment.
"Qualified
mental health care provider" includes:
(1) A physician licensed pursuant to
chapter 453, who is board certified in psychiatry or another mental or
behavioral health care area;
(2) A physician assistant licensed
pursuant to chapter 453, who is trained in psychiatry or mental health;
(3) A psychologist licensed pursuant to
chapter 465;
(4) A clinical social worker licensed
pursuant to chapter 467E;
(5) A marriage and family therapist
licensed pursuant to chapter 451J;
(6) A mental health counselor licensed
pursuant to chapter 453D;
(7) A substance abuse counselor
certified pursuant to section 321-193(10); or
(8) An advanced practice registered nurse licensed pursuant to chapter 457, who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization."
SECTION 3. Section 432D-23, Hawaii Revised Statutes, is amended to read as follows:
"§432D-23 Required provisions and
benefits. Notwithstanding any
provision of law to the contrary, each policy, contract, plan, or agreement
issued in the State after January 1, 1995, by health maintenance organizations
pursuant to this chapter, shall include benefits provided in sections
431:10-212, 431:10A-115, 431:10A-115.5, 431:10A-116, 431:10A-116.2,
431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121,
431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-134,
431:10A-140, and [431:10A-134,] 431:10A- , and
chapter 431M."
SECTION 4. The coverage required under sections 1, 2, and 3 of this Act shall apply to all plans under Medicaid managed care programs in the State.
SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.
SECTION 6. This Act shall take effect on July 1, 2026; provided that sections 1, 2, and 3 shall apply to all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2026; provided further that section 4 shall take effect upon approval of the Hawaii Medicaid state plan by the Centers for Medicare and Medicaid Services.
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INTRODUCED BY: |
_____________________________ |
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Report Title:
Health Insurance; Mandated Coverage; Annual Mental Health Wellness Examination; Medicaid
Description:
Beginning 1/1/2027, requires all health insurers in the state, including Medicaid managed care programs, to cover annual mental health wellness examinations.
The summary description
of legislation appearing on this page is for informational purposes only and is
not legislation or evidence of legislative intent.