HD43 - Report of the Special Advisory Commission on Mandated Health Insurance Benefits on Section 38.2-3412 of the Code of Virginia, House Bill 1329 (1991) and House Joint Resolution 206 (1992)
Executive Summary: Section 38.2-3412 of the of the Code of Virginia requires that individual and group accident and sickness insurance policies and subscription contracts that provide coverage to a family member contain coverage for a minimum of 30 days of inpatient treatment for mental, emotional, and nervous disorders. The current language requires coverage for treatment in a mental or general hospital. These disorders include drug and alcohol dependency, unless the insured or subscriber has coverage for such treatment pursuant to § 38.2-3413. Section 38.2-3412 (Appendix A) also requires that insurers and health services plans "make available," to group policyholders only, coverage for outpatient treatment for mental, emotional, and nervous disorders. The statute allows the coinsurance factor to be up to 50%. The maximum level of benefits for any given year may be no less than $1,000. The Advisory Commission's review of § 38.2-3412 was initiated as a result of a request by the House Committee on Corporations, Insurance and Banking (CIB) to evaluate 1991 House Bill 1329 (Appendix B), a proposed revision to the current statute. House Bill 1329 was introduced in 1991 by Delegate Robert S. Bloxom (R-Accomack). House Bill 1329 was proposed as a result of an 18-month study of the adequacy of insurance benefits for people receiving treatment or care for all mental disabilities. A task force was established to conduct the study pursuant to 1989 House Joint Resolution 319 and was extended by 1990 House Joint Resolution 42. The task force membership included representatives of health care providers, insurers, the business community, relevant state agencies, and other organizations. The Advisory Commission held a public hearing to receive comments on House Bill 1329 from all interested parties during a meeting held October 7, 1991. Twelve representatives of various organizations presented oral comments at the hearing. In addition, written comments were received from 10 individuals and organizations. The Advisory Commission's review of House Bill 1329 was continued into 1992 to allow for a full examination of existing § 38.2-3412. In addition to these issues, 1992 House Joint Resolution 206 (Appendix C) requests the Advisory Commission to study the need for insurance coverage parity among mental and physical illness. The Advisory Commission chose to study this issue concurrently with the proposed revision of § 38.2-3412. The Advisory Commission held a two-part public hearing on these mental health issues during its June 1, and July 13, 1992 meetings. Twenty-six speakers were heard and written comments were received from many individuals and organizations. Proposals recommending alternative revisions to § 38.2-3412 and House Bill 1329 were submitted by the Virginians for Mental Health Equity (VMHE), Blue Cross and Blue Shield of Virginia (BCBSVA), and Blue Cross and Blue Shield of the National Capital Area (BCBSNCA). Each proposal recommended the addition of partial hospitalization and outpatient treatment benefits in lieu of some portion of the current 30-day inpatient treatment benefit in a largely cost-neutral manner. |
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