1     
MENTAL HEALTH ACCESS AMENDMENTS

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Luz Escamilla

5     
House Sponsor: Stewart E. Barlow

6     

7     LONG TITLE
8     General Description:
9          This bill modifies an insurer's responsibilities for mental health coverage.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms; and
13          ▸     requires a health benefit plan to reimburse for telehealth services for a mental health
14     condition if certain conditions are met.
15     Money Appropriated in this Bill:
16          None
17     Other Special Clauses:
18          This bill provides a special effective date.
19     Utah Code Sections Affected:
20     AMENDS:
21          31A-22-649.5, as enacted by Laws of Utah 2020, Chapter 119
22     

23     Be it enacted by the Legislature of the state of Utah:
24          Section 1. Section 31A-22-649.5 is amended to read:
25          31A-22-649.5. Insurance parity for telemedicine services.
26          (1) As used in this section:
27          (a) "Mental health condition" means the same as that term is defined in Section
28     31A-22-625.
29          [(a)] (b) "Telehealth services" means the same as that term is defined in Section
30     26-60-102.
31          [(b)] (c) "Telemedicine services" means the same as that term is defined in Section
32     26-60-102.
33          (2) Notwithstanding the provisions of Section 31A-22-618.5, a health benefit plan
34     offered in the individual market, the small group market, or the large group market [and
35     entered into or renewed on or after January 1, 2021,] shall:
36          (a) provide coverage for telemedicine services that are covered by Medicare; [and]
37          (b) reimburse, at a commercially reasonable rate, a network provider that provides the
38     telemedicine services described in Subsection (2)(a)[.]; and
39          (c) provide coverage for medically necessary treatment of a mental health condition
40     through telehealth services if:
41          (i) the health benefit plan provides coverage for the treatment of the mental health
42     condition through in person services; and
43          (ii) the insurer determines treatment of the mental health condition through telehealth
44     services meets the appropriate standard of care.
45          (3) Notwithstanding Section 31A-45-303, a health benefit plan providing treatment
46     under Subsection (2) may not impose originating site restrictions, geographic restrictions, or
47     distance-based restrictions.
48          Section 2. Effective date.
49          If approved by two-thirds of all the members elected to each house, this bill takes effect
50     upon approval by the governor, or the day following the constitutional time limit of Utah
51     Constitution, Article VII, Section 8, without the governor's signature, or in the case of a veto,
52     the date of veto override.