Senator Luz Escamilla proposes the following substitute bill:


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          None
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.