Report Title:

Mandatory Drug/Alcohol Screening and Counseling Benefit

Description:

Requires health insurers, hospital and medical services associations, and health maintenance organizations to provide drug/alcohol screening and counseling as a covered benefit in emergency rooms or as part of primary care when the doctor providing the services has good reason to suspect substance abuse.

THE SENATE

S.B. NO.

1443

TWENTY-THIRD LEGISLATURE, 2005

 

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

relating to health insurance.

 

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

SECTION 1. The legislature finds that screening individuals for substance abuse, counseling those who show risky behavior, and referring people to substance abuse treatment if needed are remarkably effective techniques to reduce alcohol and drug problems. Sometimes, doctors are not paid to screen and counsel for alcohol and drug abuse in the same way that they are for other common conditions like diabetes and depression, and therefore many may choose not to do so.

The purpose of this Act is to require alcohol and drug abuse screening and counseling as a covered benefit when provided in an emergency room or as routine primary care.

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-    Alcohol and drug abuse screening and counseling in emergency room or routine primary care; 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, 2005, shall provide as a covered benefit, not as an employer option, alcohol and drug abuse screening and counseling that is provided either in the emergency room or as part of routine primary care, when the attending physician has good reason to suspect alcohol or drug abuse in the patient and provides the service to a patient covered under the policy, contract, plan, or agreement.

(b) 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 2005 when annual information is made available to policyholders, or in any other mailing to policyholders, but in no case later than December 31, 2005."

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

"§432:1-    Alcohol and drug abuse screening and counseling in emergency room or routine primary care; 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, 2005, shall provide as a covered benefit, not as an employer option, alcohol and drug abuse screening and counseling that is provided either in the emergency room or as part of routine primary care, when the attending physician has good reason to suspect alcohol or drug abuse in the patient and provides the service to a patient covered under the service plan, policy, contract, or agreement.

(b) 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 2005 when annual information is made available to members, or in any other mailing to members, but in no case later than December 31, 2005."

SECTION 4. 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-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, [and] 431:10A-121, and 431:10A-   , and chapter 431M."

SECTION 5. The benefit to be provided by health maintenance organizations corresponding to the benefit provided under section 431:10A-   , Hawaii Revised Statutes, as contained in the amendment to section 432D-23, Hawaii Revised Statutes, in section 4 of this Act, shall take effect for all policies, contracts, plans, or agreements issued in the State after December 31, 2005.

SECTION 6. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.

INTRODUCED BY:

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