Rep. Deb Conroy

Filed: 4/19/2021

 

 


 

 


 
10200HB2595ham001LRB102 10633 BMS 25207 a

1
AMENDMENT TO HOUSE BILL 2595

2    AMENDMENT NO. ______. Amend House Bill 2595 by replacing
3lines 11 through 21 on page 11 with the following:
4"Manual of Mental Disorders. "Mental,"; and
 
5on page 27, by replacing lines 17 through 20 with the
6following:
7    "(2) An insurer shall not set a specific limit on the
8duration of benefits or coverage of medically necessary
9treatment of mental, emotional, nervous, or substance use
10disorders or conditions or limit coverage only to alleviation
11of the insured's current symptoms; insurers shall base the
12duration of treatment on the insured's individual needs,
13including treating the insured's underlying mental, emotional,
14nervous, or substance use disorders or conditions and
15comorbidities."; and
 
16on page 28, lines 6 and 7, by replacing "rescission,

 

 

10200HB2595ham001- 2 -LRB102 10633 BMS 25207 a

1cancellation, or modification" with "cancellation or
2modification"; and
 
3on page 28, line 8, after "eligibility.", by inserting
4"Nothing in this Section shall require the insurer to cover a
5treatment when the authorization was granted based on a
6material misrepresentation by the insured, the policyholder,
7or the provider. As used in this paragraph, "material" means a
8fact or situation that is not merely technical in nature and
9results in or could result in a substantial change in the
10situation."; and
 
11on page 29, line 7, after "apply", by inserting "without
12modification"; and
 
13on page 29, line 8, by replacing "versions" with "version";
14and
 
15on page 29, line 9, by replacing "the nonprofit" with "an
16unaffiliated nonprofit"; and
 
17on page 30, immediately below line 4, by inserting the
18following:
19    "This subsection does not prohibit an insurer from
20applying utilization review criteria that were developed in
21accordance with subsection (k) to health care services and

 

 

10200HB2595ham001- 3 -LRB102 10633 BMS 25207 a

1benefits for mental, emotional, and nervous disorders or
2conditions that:
3        (1) are outside the scope of the criteria and
4    guidelines set forth in the sources specified in
5    subsection (l); or
6        (2) relate to advancements in technology or types of
7    care that are not covered in the most recent versions of
8    the sources specified in subsection (l)."; and
 
9on page 32, lines 22 and 23, by deleting "in accordance with
10Section 1016 of this Code"; and
 
11on page 32, line 24, by replacing "$5,000 and $20,000" with
12"$1,000 and $5,000"; and
 
13on page 48, lines 25 and 26, by replacing "This Act takes
14effect upon becoming law" with "This Act takes effect January
151, 2022".