Definition


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Legislation Signed into Law

2019

Primary Focus Medical Management Limitations; Mandated benefit: Other; Enforcement: Reporting Requirement
Title/Description Omnibus Health and Human Services appropriation bill
Citation Minnesota Statutes 2018, section 62Q
Summary

The bill prohibits individual and group health insurance policies from applying NQTLs on MH/SUD benefits that are not also equitably applied to med/surgical benefits. Additionally, the bill requires mental health therapy visits and medication maintenance visits to be considered primary care visits for the purpose of cost-sharing requirements. The bill also requires the Commissioner of Commerce with the Commissioner of Health to submit a report to the legislature detailing parity overview and enforcement activities. Such report must be written in nontechnical, readily understandable language and must be made available to the public

Effective Date 1/1/2020; 7/1/2019

2018

Primary Focus Mandated Benefit: Early Intensive Developmental and Behavioral Intervention (Autism Spectrum Disorder)
Title/Description Early Intensive Developmental and Behavioral Intervention Benefit
Citation Minn. Stat. § 256B.0949
Summary

Authorizes the early intensive developmental and behavioral intervention (EIDBI) benefit to provide early intensive intervention to a person with an autism spectrum disorder or a related condition. This benefit must provide coverage for a comprehensive, multidisciplinary evaluation, ongoing progress monitoring, and medically necessary early intensive treatment of autism spectrum disorder or a related condition. Nothing in this section shall preclude coverage for other medical assistance benefits based on a person’s diagnosis of an autism spectrum disorder or a related condition, including, but not limited to, coverage under section 256B.0943 of children’s therapeutic services and supports.

Effective Date 8/1/2018
Notes

Enacted by 2013 Minn. H.F. No. 1233; most recently amended by Minn. S.F. No. 3326.

2015-2016

SF1458
Introduced 3/2015
Sponsor Sen. Lourey
Status Signed into Law 5/2015
Summary

Among many other things, this comprehensive bill changed a section of the state insurance law so that mental health crisis services are considered emergency services. It also requires Medicaid plans to cover consultation services provided by licensed clinical social workers and licensed marriage and family therapists to a primary care physician.

Primary Focus Mandated Benefit: Coverage for Autism Spectrum Disorder
Title/Description Coverage for Autism Spectrum Disorder
Citation Minn. Stat. § 62A.3094
Summary

(a) A health plan issued to a large employer, as defined in section 62Q.18, subdivision 1, must provide coverage for the diagnosis, evaluation, multidisciplinary assessment, and medically necessary care of children under 18 with autism spectrum disorders, including but not limited to the following:
(1) early intensive behavioral and developmental therapy based in behavioral and developmental science, including, but not limited to, all types of applied behavior analysis, intensive early intervention behavior therapy, and intensive behavior intervention;
(2) neurodevelopmental and behavioral health treatments and management;
(3) speech therapy;
(4) occupational therapy;
(5) physical therapy; and
(6) medications.

Effective Date 1/1/2015
Notes

Enacted by Minn. H.F. No. 1233.

2013-2014

Primary Focus Mandated Benefit: Mental Health and Substance Use Disorder Services
Title/Description Essential Health Benefit Package Requirements
Citation Minn. Stat. § 62Q.81
Summary

Subdivision 1. Essential health benefits package.
(a) Health plan companies offering individual and small group health plans must include the essential health benefits package required under section 1302(a) of the Affordable Care Act and as described in this subdivision.
(b) The essential health benefits package means coverage that:
(1) provides essential health benefits as outlined in the Affordable Care Act;
(2) limits cost-sharing for such coverage in accordance with the Affordable Care Act, as described in subdivision 2; and
(3) subject to subdivision 3, provides bronze, silver, gold, or platinum level of coverage in accordance with the Affordable Care Act.
Subd. 4. Essential health benefits; definition. — For purposes of this section, “essential health benefits” has the meaning given under section 1302(b) of the Affordable Care Act and includes:
. . . (6) mental health and substance use disorder services, including behavioral health treatment;

Effective Date 1/1/2014
Notes

Enacted by Minn. H.F. No. 779.

Primary Focus Parity: General
Title/Description Alcoholism, Mental Health, and Chemical Dependency Services
Citation Minn. Stat. § 62Q.47
Summary

All health plans must meet the requirements of the federal Mental Health Parity Act of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and federal guidance or regulations issued under, those acts.

Effective Date 5/24/2013
Notes

Enacted by Minn. H.F. No. 779.

HF779
Senate Bill SF662
Introduced 2/2013
Sponsor Rep. Atkins and Sen. Lourey
Status Signed into Law 5/2013
Summary This bill changed the state insurance law about behavioral health coverage, among many other things. Insurance plans have to meet the requirements of the Federal Parity Law and any regulations or other federal guidance issued regarding the Federal Parity Law.
HF1233
Senate Bill SF1034
Introduced 3/2013
Sponsor Rep. Huntley and Sen. Lourey
Status Signed into Law 5/2013
Summary

Among many other things, this bill changed the state insurance law to add the section that requires insurance plans to cover services for autism and it also requires state employee plans to abide by this section. It also changed state law so that Medicaid plans must cover consultation provided by psychologists and an advanced practice registered nurses certified in psychiatric mental health to a primary care physician (a summary of the section of the state insurance law about autism coverage can be found at the bottom of the page).

2001-2002

Primary Focus Mandated Benefit: Court-Order Mental Health Coverage
Title/Description Coverage for Court-Ordered Mental Health Services
Citation Minn. Stat. § 62Q.535
Summary

All health plan companies that provide coverage for mental health services must cover or provide mental health services ordered by a court of competent jurisdiction under a court order that is issued on the basis of a behavioral care evaluation performed by a licensed psychiatrist or a doctoral level licensed psychologist, which includes a diagnosis and an individual treatment plan for care in the most appropriate, least restrictive environment.

Effective Date 7/1/2002
Notes

Enacted by Minn. H.F. No. 3163.

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Common Violations

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