Minnesota Session Laws - 1993, Regular Session

  
    Laws of Minnesota 1993 

                         CHAPTER 81-H.F.No. 670 
           An act relating to insurance; health; regulating 
          benefits for outpatient mental or nervous disorder 
          treatment; amending Minnesota Statutes 1992, section 
          62A.152, subdivisions 2 and 3. 
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
    Section 1.  Minnesota Statutes 1992, section 62A.152, 
subdivision 2, is amended to read: 
    Subd. 2.  [MINIMUM BENEFITS.] (a) All group policies and 
all group subscriber contracts providing benefits for mental or 
nervous disorder treatments in a hospital shall also provide 
coverage on the same basis as coverage for other benefits for at 
least 80 percent of the cost of the usual and customary charges 
of the first ten hours of treatment incurred over a 12-month 
benefit period, for mental or nervous disorder consultation, 
diagnosis and treatment services delivered while the insured 
person is not a bed patient in a hospital, and at least 75 
percent of the cost of the usual and customary charges for any 
additional hours of treatment during the same 12-month benefit 
period for serious or persistent mental or nervous disorders, if 
the services are furnished by (1) a licensed or accredited 
hospital, (2) a community mental health center or mental health 
clinic approved or licensed by the commissioner of human 
services or other authorized state agency, or (3) a 
psychological practitioner licensed under the provisions of 
sections 148.88 to 148.98, (4) a licensed psychologist licensed 
under the provisions of sections 148.88 to 148.98, or (5) a 
psychiatrist licensed under chapter 147 mental health 
professional, as defined in section 245.462, subdivision 18, 
clauses (1) to (5); and 245.4871, subdivision 27, clauses (1) to 
(5).  Prior authorization from an accident and health insurance 
company, or a nonprofit health service corporation, shall be 
required for an extension of coverage beyond ten hours of 
treatment.  This prior authorization must be based upon the 
severity of the disorder, the patient's risk of deterioration 
without ongoing treatment and maintenance, degree of functional 
impairment, and a concise treatment plan.  Authorization for 
extended treatment may be limited to a maximum of 30 visit hours 
during any 12-month benefit period. 
    (b) For purposes of this section, covered treatment for a 
minor includes treatment for the family if family therapy is 
recommended by a provider listed in paragraph (a).  For purposes 
of determining benefits under this section, "hours of treatment" 
means treatment rendered on an individual or single-family 
basis.  If treatment is rendered on a group basis, the hours of 
covered group treatment must be provided at a ratio of no less 
than two group treatment sessions to one individual treatment 
hour.  
    Sec. 2.  Minnesota Statutes 1992, section 62A.152, 
subdivision 3, is amended to read: 
    Subd. 3.  [PROVIDER DISCRIMINATION PROHIBITED.] All group 
policies and group subscriber contracts that provide benefits 
for mental or nervous disorder treatments in a hospital must 
provide direct reimbursement for those services if performed by 
a psychological practitioner or a licensed psychologist mental 
health professional, as defined in section 245.462, subdivision 
18, clauses (1) to (5); and 245.4871, subdivision 27, clauses 
(1) to (5), to the extent that the services and treatment are 
within the scope of psychological practitioner or licensed 
psychologist mental health professional licensure.  
    This subdivision is intended to provide payment of benefits 
for mental or nervous disorder treatments performed by a 
psychological practitioner or a licensed psychologist mental 
health professional in a hospital and is not intended to change 
or add benefits for those services provided in policies or 
contracts to which this subdivision applies. 
    Sec. 3.  [EFFECTIVE DATE.] 
    Sections 1 and 2 are effective August 1, 1993, and apply to 
policies and contracts issued or renewed to provide coverage for 
Minnesota residents on or after that date. 
    Presented to the governor April 30, 1993 
    Signed by the governor May 3, 1993, 4:35 p.m.