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Name, Date, Info &
Status:
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Coverage Limits: | Potential Parity Loopholes: |
| Federal Bill: H. R. 6983: The Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008, 9/22/2008, by Rep. Patrick Kennedy (RI) Enacted 10/3/2008 as part of the Emergency Economic Stabilization Act (HR 1424) |
None, "no more restrictive than those requirements and limitations placed on medical/surgical benefits" | 1. Small businesses of less than 50 employees not bound by law, voluntary compliance. 2. If cost of all medical/surgical plus addiction & mental health coverage increases 2% 1st year & 1% subsequent years, business not bound by law but compliance is voluntary. |
| VT State Law: Sec. 4089b. Health Insurance Coverage, Mental Health and Substance Abuse. 2006 Health Care Reform: Sec. 19m74(a)(b), as added by 191 (H. 861), L. 2005, Enacted 5/25/2006 |
None: ""Mental health condition" means any condition or disorder...that falls under any of the diagnostic categories listed in the mental disorders section of the international classification of disease as periodically revised. 3.(b) A health insurance plan shall provide coverage for treatment of a mental health condition and shall: (1) not establish any rate, term, or condition that places a greater financial burden on an insured for access to treatment for a mental health condition than for access to treatment for a physical health condition; (3) make any deductible or out-of-pocket limits required under a health insurance plan comprehensive for coverage of both mental health and physical health conditions."
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None, carrying insurance not mandated, but if a company or government plan is carried, it is bound by this parity law
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| RI State Law Title 27 Chapter 27-38.2.1-5 Enacted 8/21/1996 |
On the surface, None: "Every health care insurer that delivers or issues for delivery or renews in this state a contract, plan, or policy except contracts providing supplemental coverage to Medicare or other governmental programs, shall provide coverage for the medical treatment of mental illness and substance abuse under the same terms and conditions as that coverage is provided for other illnesses and diseases. Insurance coverage offered pursuant to this statute must include the same durational limits, amount limits, deductibles, and co-insurance factors for mental illness as for other illnesses and diseases" "The health insurers, when making the determination of medically necessary and appropriate treatment, must do so in a manner consistent with that used to make the determination for the treatment of other diseases or injuries covered under the health insurance policy or agreement."
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Sec. 27-38.2-4 Limitations of coverage.-(b)...outpatient services, with the exception of ...medication visits...provided for up to thirty (30) visits in any calendar year; outpatient services for substance abuse treatment...thirty (30) hours...community residential care...up to thirty (30) days...detoxification...up to five (5)...occurrences or thirty (30) days in any calendar year whichever comes first." |
| RI, 2007 -- S 0325 Would amend previous Senate Bill regarding above current RI law Introduced by Senators Perry, Gallo, C. Levesque, Goodwin, & Miller on 2/07/2007 Referred to Senate Health & Human Services Committee 3/21/2007: Scheduled for hearing 3/21.2007: Committee recommended measure be held for further study |
None, on the surface: 27-38.2-1. Mental illness coverage.-"...and (b) ensure that reimbursement for professional providers providing medical treatment of mental illness and substance abuse is determined using the same methodology as reimbursement for professional providers of medical services...In no case shall professional provider reimbursement paid by a health care insurer for mental illness coverage be at a level that is not comparable to reimbursements paid by such insurer for medical services of a similar level and requiring similar expertise." |
Still keeps above limitations. |
| RI, 2007 -- H 5738 Would amend previous House Bill regarding above current RI law Introduced by Reps. Ajello, Dennigan, Handy, Picard, & Lewiss on 2/28/2007 2/28/2007: Introduced, referred to House Corporations Committee 3/6/2007: Scheduled for hearing and/or consideration 3/6/2007: Committee recommended measure be held for further study. |
None, on the surface:27-38.2-1. Mental Illness coverage--..."shall provide coverage for the medical treatment of (delete word "serious") mental illness and substance abuse under the same terms and conditions as such coverage is provided for other illnesses and diseases. Insurance coverage offered pursuant to this statute must include the same durational limits, amount limits, deductibles, and co-insurance factors for (delete word "serious") mental illnesses and diseases." 27-38.2-4. Limitations of Coverage: Deletes the following passage: "Inpatient coverage in cases where continuous hospitalization is medically necessary shall be limited to ninety (90) consecutive days." | Still keeps above limitations. |