62Q.137 CHEMICAL DEPENDENCY TREATMENT; COVERAGE.
(a) Any health plan that provides coverage for chemical dependency treatment must cover
chemical dependency treatment provided to an enrollee by the Department of Corrections
while the enrollee is committed to the custody of the commissioner of corrections following a
conviction for a first-degree driving while impaired offense under section
if: (1) a
court of competent jurisdiction makes a preliminary determination based on a chemical use
assessment conducted under section
that treatment may be appropriate and includes this
determination as part of the sentencing order; and (2) the Department of Corrections makes a
determination based on a chemical assessment conducted while the individual is in the custody
of the department that treatment is appropriate. Treatment provided by the Department of
Corrections that meets the requirements of this section shall not be subject to a separate medical
necessity determination under the health plan company's utilization review procedures.
(b) The health plan company must be given a copy of the court's preliminary determination
and supporting documents and the assessment conducted by the Department of Corrections.
(c) Payment rates for treatment provided by the Department of Corrections shall not exceed
the lowest rate for outpatient chemical dependency treatment paid by the health plan company to
a participating provider of the health plan company.
(d) For purposes of this section, chemical dependency treatment means all covered services
that are intended to treat chemical dependency and that are covered by the enrollee's health
plan or by law.
History: 1Sp2001 c 9 art 19 s 1; 2002 c 379 art 1 s 113