SF 1187

as introduced - 89th Legislature (2015 - 2016) Posted on 02/27/2015 09:36am

A bill for an act
relating to insurance; requiring coverage for treatment and services provided by
mental health professionals and clinical trainees; requiring a denial of a claim
for mental health services be made or reviewed by a licensed mental health
professional; amending Minnesota Statutes 2014, section 62A.15, subdivision 4,
by adding a subdivision.

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

Section 1.

Minnesota Statutes 2014, section 62A.15, is amended by adding a
subdivision to read:

new text begin Subd. 3c. new text end

new text begin Mental health services. new text end

new text begin All benefits provided by a policy or contract
referred to in subdivision 1 relating to expenses incurred for mental health treatment or
services provided by a mental health professional must also include treatment and services
provided by a clinical trainee to the extent that the services and treatment are within the
scope of practice of the clinical trainee according to Minnesota Rules, part 9505.0371,
subpart 5, item C.
new text end

new text begin This subdivision is intended to provide equal payment of benefits for mental health
treatment and services provided by a mental health professional or clinical trainee as
defined in this subdivision and is not intended to change or add to the benefits provided
for in those policies or contracts.
new text end

Sec. 2.

Minnesota Statutes 2014, section 62A.15, subdivision 4, is amended to read:

Subd. 4.

Denial of benefits.

(a) No carrier referred to in subdivision 1 may, in the
payment of claims to employees in this state, deny benefits payable for services covered
by the policy or contract if the services are lawfully performed by a licensed chiropractor,
licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, or a
licensed acupuncture practitioner.

(b) When carriers referred to in subdivision 1 make claim determinations concerning
the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any
of these determinations that are made by health care professionals must be made by, or
under the direction of, or subject to the review of licensed doctors of chiropractic.

(c) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of acupuncture
services for individuals in this state performed by a licensed acupuncture practitioner, a
denial of payment claim determination that is made by a health professional must be made
by, under the direction of, or subject to the review of a licensed acupuncture practitioner.

new text begin (d) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of mental health
services for individuals in this state performed by a licensed mental health professional
or clinical trainee, a denial of payment claim determination that is made by a health
professional must be made by, under the direction of, or subject to the review of a licensed
mental health professional.
new text end