Chapter
262
2006 -- S 2706 SUBSTITUTE A AS AMENDED
Enacted 07/03/06
A N A
C T
RELATING TO HEALTH
AND SAFETY
Introduced By: Senators
Perry, Goodwin, Roberts, C Levesque, and Walaska
Date Introduced: February
14, 2006
It is enacted
by the General Assembly as follows:
SECTION
1. Chapter 27-18 of the General Laws entitled "Accident and Sickness
Insurance
Policies" is hereby amended by adding thereto the following section:
27-18-66.
Tobacco cessation programs. – (1) Every individual or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or policy
shall
not
be required to include coverage for prescription nicotine replacement therapy.
(2)
As used in this section, smoking cessation treatment includes the use of an
over-the-
counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
Health insurance contracts, plans, or policies to which this section applies,
may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
This section shall not apply to insurance coverage providing benefits for:
(a)
hospital confinement indemnity;
(b)
disability income;
(c)
accident only;
(d)
long-term care;
(e)
Medicare supplement;
(f)
limited benefit health;
(g)
specified disease indemnity;
(h)
sickness or bodily injury or death by accident or both; and
(i) other limited
benefit policies.
SECTION
2. Chapter 27-19 of the General Laws entitled "Nonprofit Hospital Service
Corporations"
is hereby amended by adding thereto the following section:
27-19-57.
Tobacco cessation programs. -- (1) Every individual or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not
be required to include coverage for prescription nicotine replacement therapy.
(2)
As used in this section, smoking cessation treatment includes the use of an
over-the-
counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
Health insurance contracts, plans, or policies to which this section applies,
may
impose
copayments and/or deductibles for the benefits mandated by this section consistent
with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
This section shall not apply to insurance coverage providing benefits for:
(a)
hospital confinement indemnity;
(b)
disability income;
(c)
accident only;
(d)
long-term care;
(e)
Medicare supplement;
(f)
limited benefit health;
(g)
specified disease indemnity;
(h)
sickness or bodily injury or death by accident or both; and
(i) other limited benefit policies.
SECTION
3. Chapter 27-20 of the General Laws entitled "Nonprofit Medical Service
Corporations"
is hereby amended by adding thereto the following section:
27-20-53.
Tobacco cessation programs. -- (1) Every individual or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not
be required to include coverage for prescription nicotine replacement therapy.
(2)
As used in this section, smoking cessation treatment includes the use of an
over-the-
counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
Health insurance contracts, plans, or policies to which this section applies,
may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
This section shall not apply to insurance coverage providing benefits for:
(a)
hospital confinement indemnity;
(b)
disability income;
(c)
accident only;
(d)
long-term care;
(e)
Medicare supplement;
(f)
limited benefit health;
(g)
specified disease indemnity;
(h)
sickness or bodily injury or death by accident or both; and
(i)
other limited benefit policies.
SECTION
4. Chapter 27-41 of the General Laws entitled "Health Maintenance
Organizations"
is hereby amended by adding thereto the following section:
27-41-70.
Tobacco cessation programs. -- (1) Every individual or group health
insurance
contract, plan or policy delivered, issued for delivery or renewed in this
state on or after
January
1, 2007, which provides medical coverage that includes coverage for physician
services
in a
physician's office, and every policy which provides major medical or similar
comprehensive-
type
coverage, shall include coverage for smoking cessation treatment, provided that
if such
medical
coverage does not include prescription drug coverage, such contract, plan or
policy shall
not
be required to include coverage for prescription nicotine replacement therapy.
(2)
As used in this section, smoking cessation treatment includes the use of an
over-the-
counter
(OTC) or prescription US Food and Drug Administration (FDA) approved nicotine
replacement
therapy, when recommended and prescribed by a prescriber who holds prescriptive
privileges
in the state in which they are licensed, and used in combination with an annual
outpatient
benefit of eight (8) one-half (1/2) hour smoking cessation counseling sessions
provided
by a
qualified practitioner for each covered individual. Smoking cessation treatment
may be
further
defined through regulation promulgated by the health insurance commissioner.
(3)
Health insurance contracts, plans, or policies to which this section applies,
may
impose
copayments and/or deductibles for the benefits mandated by this section
consistent with
the
contracts', plans' or policies' copayments and/or deductibles for physician
services and
medications.
Nothing contained in this section shall impact the reimbursement, medical
necessity
or
utilization review, managed care, or case management practices of these health
insurance
contracts,
plans or policies.
(4)
This section shall not apply to insurance coverage providing benefits for:
(a)
hospital confinement indemnity;
(b)
disability income;
(c)
accident only;
(d)
long-term care;
(e)
Medicare supplement;
(f)
limited benefit health;
(g)
specified disease indemnity;
(h)
sickness or bodily injury or death by accident or both; and
(i) other limited benefit policies.
SECTION
5. This act shall take effect upon passage.
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LC02402/SUB A/2
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