SB 46: RELATING TO INSURANCE.

THE SENATE	S.B. NO.	46
THIRTY-THIRD LEGISLATURE, 2025
STATE OF HAWAII

A BILL FOR AN ACT

 

 

RELATING TO INSURANCE.

 

 

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

 

     SECTION 1.  Chapter 431, Hawaii Revised Statutes, is amended by adding a new section to article 10A, part I, to be appropriately designated and to read as follows:

     "§431:10A-     Annual mental health wellness examination coverage.  (a)  Each individual and group policy of accident and health or sickness insurance issued or renewed in the State after December 31, 2025, except for policies that only provide coverage for a specified disease or other limited benefit coverage as described in section 431:10A-607, shall provide coverage for an annual mental health wellness examination; provided that each covered annual mental health wellness examination:

     (1)  Shall be:

          (A)  Up to sixty minutes in duration;

          (B)  Performed by a qualified mental health care provider; and

          (C)  Exempt from any deductible or copayment provisions that may be in force in an applicable policy or contract; and

     (2)  May include:

          (A)  Observation;

          (B)  A behavioral health screening;

          (C)  Education and consultation on healthy lifestyle changes;

          (D)  Referrals for ongoing treatment, mental health services, and other necessary supports;

          (E)  Discussion of potential options for medication;

          (F)  Age-appropriate screenings or observations to understand a covered person's mental health history, personal history, and mental or cognitive state; and

          (G)  If appropriate, relevant adult input through screenings, interviews, and questions.

     (b)  The coverage required by this section shall:

     (1)  Be at least as extensive as coverage for a physical examination; and

     (2)  Comply with the requirements of the Mental Health Parity and Addiction Equity Act of 2008.

     (c)  Each accident and health or sickness insurer shall reimburse any qualified mental health care provider complying with this section for all costs associated with the coverage required by this section.

     (d)  For purposes of this section:

     "Mental health wellness examination" means an examination to identify a covered person's behavioral or mental health needs and any appropriate resources for treatment.

     "Qualified mental health care provider" includes:

     (1)  A physician licensed pursuant to chapter 453, who is board certified in psychiatry or another mental or behavioral health care area;

     (2)  A physician assistant licensed pursuant to chapter 453, who is trained in psychiatry or mental health;

     (3)  A psychologist licensed pursuant to chapter 465;

     (4)  A clinical social worker licensed pursuant to chapter 467E;

     (5)  A marriage and family therapist licensed pursuant to chapter 451J;

     (6)  A mental health counselor licensed pursuant to chapter 453D;

     (7)  A substance abuse counselor certified pursuant to section 321-193(10); or

     (8)  An advanced practice registered nurse licensed pursuant to chapter 457, who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization."

     SECTION 2.  Chapter 432, Hawaii Revised Statutes, is amended by adding a new section to article I to be appropriately designated and to read as follows:

     "§432:1-     Annual mental health wellness examination coverage.  (a)  Each individual or group hospital or medical service plan contract issued or renewed in this State after December 31, 2025, shall provide coverage for an annual mental health wellness examination; provided that each covered annual mental health wellness examination:

     (1)  Shall be:

          (A)  Up to sixty minutes in duration;

          (B)  Performed by a qualified mental health care provider; and

          (C)  Exempt from any deductible or copayment provisions that may be in force in any contract; and

     (2)  May include:

          (A)  Observation;

          (B)  A behavioral health screening;

          (C)  Education and consultation on healthy lifestyle changes;

          (D)  Referrals for ongoing treatment, mental health services, and other necessary supports;

          (E)  Discussion of potential options for medication;

          (F)  Age-appropriate screenings or observations to understand a covered person's mental health history, personal history, and mental or cognitive state; and

          (G)  If appropriate, relevant adult input through screenings, interviews, and questions.

     (b)  The coverage required by this section shall:

     (1)  Be at least as extensive as coverage for a physical examination; and

     (2)  Comply with the requirements of the Mental Health Parity and Addiction Equity Act of 2008.

     (c)  Each mutual benefit society shall reimburse any qualified mental health care provider complying with this section for all costs associated with the coverage required by this section.

     (d)  For purposes of this section:

     "Mental health wellness examination" means an examination to identify a covered person's behavioral or mental health needs and any appropriate resources for treatment.

     "Qualified mental health care provider" includes:

     (1)  A physician licensed pursuant to chapter 453, who is board certified in psychiatry or another mental or behavioral health care area;

     (2)  A physician assistant licensed pursuant to chapter 453, who is trained in psychiatry or mental health;

     (3)  A psychologist licensed pursuant to chapter 465;

     (4)  A clinical social worker licensed pursuant to chapter 467E;

     (5)  A marriage and family therapist licensed pursuant to chapter 451J;

     (6)  A mental health counselor licensed pursuant to chapter 453D;

     (7)  A substance abuse counselor certified pursuant to section 321-193(10); or

     (8)  An advanced practice registered nurse licensed pursuant to chapter 457, who holds an accredited national certification in an advanced practice registered nurse psychiatric specialization."

     SECTION 3.  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‑116.2, 431:10A-116.5, 431:10A-116.6, 431:10A-119, 431:10A-120, 431:10A-121, 431:10A-122, 431:10A-125, 431:10A-126, 431:10A-132, 431:10A-133, 431:10A-134, 431:10A-140, and [431:10A-134,] 431:10A-   , and chapter 431M."

     SECTION 4.  The coverage required under sections 1, 2, and 3 of this Act shall apply to all plans under Medicaid managed care programs in the State.

     SECTION 5.  Statutory material to be repealed is bracketed and stricken.  New statutory material is underscored.

     SECTION 6.  This Act shall take effect on July 1, 2025; provided that sections 1, 2, and 3 shall apply to all policies, contracts, plans, or agreements issued or renewed in the State after December 31, 2025; provided further that section 4 shall take effect upon approval of the Hawaii medicaid state plan by the Centers for Medicare and Medicaid Services.

 

INTRODUCED BY:	_____________________________

 

 

 

Report Title:

Health Insurance; Mandated Coverage; Annual Mental Health Wellness Examination

 

Description:

Requires all health insurers in the state, including Medicaid managed care programs, to cover annual mental health wellness examinations.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.