§ 26-20-702 — Reimbursement for mental health and substance use disorder benefits

(a) As used in this section "mental health and substance
use disorder benefits" means benefits for the treatment of any
condition or disorder that involves a mental health condition or
substance use disorder that falls under any of the diagnostic
categories listed in the mental disorders section of the most
recent edition of the International Classification of Disease or
that is listed in the mental disorders section of the most
recent version of the Diagnostic and Statistical Manual of
Mental Disorders.
(b) All individual or group health insurance policies
providing coverage on an expense incurred basis, individual and
group service or indemnity type health insurance contracts
issued by any insurer, including any nonprofit corporation and
individual and group service contracts issued by a health
maintenance organization and individual and group service
contracts that provide mental health and substance use disorder
benefits shall provide reimbursement for benefits that are
delivered through the psychiatric Collaborative Care Model as
defined by the American Medical Association's most recent
procedural terminology codes and where a licensed and
credentialed primary care team consists of a primary care
provider, a care manager and a psychiatric consultant.
(c) The benefit and reimbursement requirements of
subsection (b) of this section shall not apply to any policy,
contract or service that would require the state to defray the
cost as specified in 42 U.S.C. 18031(d)(3)(B)(ii).
(d) Nothing in this section shall restrict the health
insurer's ability to apply appropriate medical management for
the services rendered.
ARTICLE 8
ANATOMICAL GIFTS AND ORGAN TRANSPLANTATION