§ 23-99-506 — Parity requirements

(a) Except as provided in § 23-99-504 , a health benefit plan that provides benefits for the diagnosis and treatment of mental illnesses shall provide the benefits under the same terms and conditions as provided for covered benefits offered under the health benefit plan for the treatment of other medical illnesses and conditions, including without limitation: (1) The duration or frequency of coverage; (2) The dollar amount of coverage; or (3) Financial requirements. (b) This subchapter does not: (1) Require equal coverage between treatments for a mental illness with coverage for preventive care; (2) Prohibit a healthcare insurer from: (A) Negotiating separate reimbursement rates and service delivery systems, including without limitation a carve-out arrangement; (B) Managing the provision of mental health benefits for mental illnesses by common methods used for other medical conditions, including without limitation preadmission screening, prior authorization of services, or other mechanisms designed to limit coverage of services or mental illnesses to mental illnesses that are deemed medically necessary; (C) Limiting covered services to covered services authorized by the health benefit plan, if the limitations are made in accordance with this subchapter; (D) Using separate but equal cost-sharing features for mental illnesses; or (E) Using a single lifetime or annual dollar limit as applicable to other medical illness; and (3) Include a Medicare or Medicaid plan or contract or any privatized risk or demonstration program for Medicare or Medicaid coverage.

Legislative History

Acts 1997, No. 1020, § 4; 2009, No. 1193, § 7.