Primary Focus: Mandated Benefit: Peer Support Title/Description: Peer Support Specialist Medicaid Coverage Citation: MCA §53-6-101 Summary: Amends MCA §53-6-101 to make services provided by behavioral health peer support specialists eligible for Medicaid coverage. Effective Date: 7/1/2019 Notes: Enacted through S30
Primary Focus: Access to Services Title/Description: Coverage for services provided under freedom of choice for mental health services. Citation: 33-30-1020, MCA Summary: Group and individual insurance contracts shall provide coverage for health services provided by marriage and family therapists. Effective Date: January 1, 2019 Notes: Enacted by Mt. HB 469.
Primary Focus: Access to Services Title/Description: Policies and certificates to provide for freedom of choice of practitioners — professional practice not enlarged. Citation: 33-22-111, MCA Summary: All policies or certificates of disability insurance, including individual, group, and blanket policies or certificates, must provide that the insured has full freedom of choice in the selection of any psychologist, licensed social worker, licensed professional counselor, licensed addiction counselor, licensed marriage and family therapist for treatment of any illness or injury within the scope and limitations of the person’s practice. Effective Date: January 1, 2019 Notes: Amended by Mt. HB 469.
HB 142 Introduced: 01/2017 Sponsor: Rep. Bishop Status: Signed Into Law 5/2017 Summary: Among other things, this bill changed the sections of the state’s insurance law related to behavioral health coverage:
It specifies that individual plans, small-group plans, and large-group plans should provide coverage for mental health conditions and substance use disorders in a way that is “no less favorable” than coverage for other medical conditions
It defines “no less favorable” as being what is specified in the Federal Parity Law and its final regulations on January 1, 2017, thereby maintaining parity protection in the individual and small-group market no matter what happens with efforts to amend the Affordable Care Act
It repeals the standalone section specifying certain coverage levels for serious mental illness and incorporates those conditions into the section regarding other mental illness and substance use disorders
It eliminates multiple restrictive annual and lifetime maximums alongs with limits on inpatient days and partial hospitalization
Primary Focus: Access to Services Title/Description: Coverage for telemedicine services. Citation: 33-22-138, MCA Summary: Each group or individual policy, certificate of disability insurance, subscriber contract, membership contract, or health care services agreement that provides coverage for health care services must provide coverage for health care services provided by a health care provider or health care facility by means of telemedicine if the services are otherwise covered by the policy, certificate, contract, or agreement, including mental health centers. Effective Date: April 5, 2013. Notes: Amended by Mt. SB 270.
SB 234 Sponsor: Sen. Gillan Status: Signed Into Law 4/2009 Summary: Among other things, this bill added the autism section to the state’s insurance law. This section of the law is summarized at the bottom of this page.
$2,000 annual maximum for outpatient care for mental health conditions
$6,000 annual maximum for substance use disorder treatment
$12,000 lifetime maximum for substance use disorder treatment (annual maximum is reduced to $2,000 when the lifetime maximum is met)
This subsection specifically excludes eating disorders besides anorexia and bulimia, developmental disorders, speech disorders, and impulse control disorders besides intermittent explosive disorder and trichotillomania.
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