§ 764g. Mental illness coverage
Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. Insurance
40 P.S. § 764g
§ 764g. Mental illness coverage
(1) “Serious mental illness” means any of the following mental illnesses as defined by the American Psychiatric Association in the most recent edition of the Diagnostic and Statistical Manual: schizophrenia, bipolar disorder, obsessive-compulsive disorder, major depressive disorder, panic disorder, anorexia nervosa, bulimia nervosa, schizoaffective disorder and delusional disorder.
(ii) The act of December 29, 1972 (P.L. 1701, No. 364),1 known as the “Health Maintenance Organization Act.”
(b) This section shall apply to any health insurance policy offered, issued or renewed on or after the effective date of this section in this Commonwealth to groups of fifty (50) or more employes: Provided, that this section shall not include the following policies: accident only, fixed indemnity, limited benefit, credit, dental, vision, specified disease, Medicare supplement, CHAMPUS (Civilian Health and Medical Program for the Uniformed Services) supplement, long-term care, disability income, workers' compensation or automobile medical payment.
(d) The Legislative Budget and Finance Committee shall undertake a study of the cost and benefits of this section eighteen (18) months after the effective date of this section. The committee shall prepare a report of its study for the General Assembly on or before June 30, 2001, and every two years thereafter.2 Such study and report shall include, but not be limited to, an analysis of the following: the effect on policy premiums; the cost benefit of extending this act to all group health insurance policies offered in this Commonwealth; the cost benefit of this enhanced level of coverage for mental illness and the cost benefit to those employers who offer policies with more liberal benefits; the identity of employers who, after the effective date of this section, provide reduced mental health insurance benefits to employes and who provided more liberal mental health insurance benefits than provided in this act; an analysis of any mental illnesses enumerated under axis 1 of the Current Diagnostic and Statistical Manual of Mental Disorders not covered under this section, with specific consideration of whether any of them should be included in the definition of serious mental illness; actions taken by the department to assure health insurance policies are in compliance with this section and that quality and access to treatment for mental health conditions are not compromised by providing coverage under this section; identify any segments of this Commonwealth's population that may be excluded from access to treatment for mental health conditions; and an analysis of the use of medical services resulting from the provision of access to mental health treatment as provided by this section.
1921, May 17, P.L. 682, No. 284, § 635.1, added 1998, Dec. 21, P.L. 1108, No. 150, § 5, effective in 120 days.
40 P.S. § 1551 et seq.
Pursuant to Act 2015, June 30, P.L. 85, No. 13, § 1(1), imd. effective, the Legislative Budget and Finance Committee shall no longer undertake studies and prepare reports of the studies for the General Assembly under 40 P.S. § 764g(d).
40 P.S. § 764g, PA ST 40 P.S. § 764g
Current through 2022 Regular Session Act 121. Some statute sections may be more current, see credits for details.
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