Second Regular Session
              Sixty-fifth General Assembly
                    STATE OF COLORADO
                                                 INTRODUCED
                                                           
                                                           
 LLS NO. 06-0067.01 Michael Dohr         SENATE BILL 06-005
                   SENATE SPONSORSHIP
 Windels,  Kester, and Takis
 
                    HOUSE SPONSORSHIP
 Solano,  and Jahn
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 Senate Committees
 House Committees
 
 
 Health and Human Services
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
                         A BILL FOR AN ACT
       Concerning mental health services coverage under health
            benefit plans.
       
       
                           Bill Summary
       
            (Note:  This summary applies to this bill as introduced and does
       not necessarily reflect any amendments that may be subsequently
       adopted.)
       
            Legislative Oversight Committee for the Continuing
       Examination of the Treatment of Persons with Mental Illness who
       are Involved in the Justice System.  Requires an individual or group
       health benefit plan that provides coverage for mental health services to
       provide coverage for services regardless of whether the services are
       voluntary or court-ordered as a result of contact with the criminal justice
       or juvenile justice system.  Specifies that the health benefit plan is
       required to provide coverage only for benefits that are medically
       necessary and otherwise covered under the plan.  Establishes that the term
       "mental health services" includes treatment for mental illness and
       treatment for biologically based mental illness.
       
       
       
       Be it enacted by the General Assembly of the State of Colorado:
            SECTION 1.  Part 1 of article 16 of title 10, Colorado Revised
       Statutes, is amended BY THE ADDITION OF A NEW SECTION to
       read:
            10-16-104.8.  Mental health services coverage - court-ordered. 
       (1)  An individual or group health benefit plan delivered or
       issued for delivery within this state by an entity subject to the
       provisions of part 2, 3, or 4 of this article that provides
       coverage for mental health services shall provide coverage for
       mental health services regardless of whether the services are
       voluntary or court-ordered as a result of contact with the
       criminal justice or juvenile justice system.  The health benefit
       plan shall be required to provide coverage only for benefits
       that are medically necessary and otherwise covered under the
       plan.  Such coverage shall be subject to applicable in- or  out-of-
       network copayment, deductible, and policy maximums and
       limitations.  The court order for mental health services shall
       not mandate the type of mental health services or the length
       and frequency of treatment that is to be covered by the health
       benefit plan.  The health benefit plan shall only be responsible
       for those benefits that are covered by the health benefit plan
       and not those that are court-ordered that exceed the scope of
       benefits as provided by the health plan.  Determination of
       medically necessary mental health services shall be made by
       the health benefit plan based on the submitted clinical
       treatment plan from a provider who is designated by and
       affiliated with the health benefit plan.  Health benefit plans
       issued by an entity subject to the provisions of part 4 of this
       article may provide that the benefits required pursuant to this
       section shall be covered benefits only if the services are deemed
       medically necessary and are rendered by a provider who is
       designated by and affiliated with the health maintenance
       organization.
            (2)  Nothing in this section shall mandate or be construed
       to mandate that a health benefit plan provide coverage for
       mental health services.
            (3)  For purposes of this section, "mental health services"
       includes treatment for mental illness as described in section
       10-16-104 (5) and treatment for biologically based mental
       illness as described in section 10-16-104 (5.5).
            (4)  For purposes of this section, "mental health services"
       does not include services that are outside the scope of the
       contract.  Such mental health services that are outside the
       scope of the contract may include: services that are custodial
       or residential in nature, probation assessments, testing for
       ability, aptitude or intelligence, or performing evaluations,
       such as placement evaluations, custody evaluations,
       reunification assessments, or community risk assessments for
       any purpose other than mental health treatment.
            SECTION 2.  Safety clause.  The general assembly hereby finds,
       determines, and declares that this act is necessary for the immediate
       preservation of the public peace, health, and safety.