Chapter
293
2006 -- H 7467 SUBSTITUTE A
Enacted 07/03/06
A N A C T
RELATING
TO INSURANCE -- TOBACCO CESSATION COVERAGE
Introduced
By: Representative Richard W. Singleton
Date
Introduced: February 16, 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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LC01582/SUB
A
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