Chapter 291
2009 -- S 0540 SUBSTITUTE A
Enacted 11/13/09
A N A C T
RELATING TO INSURANCE
Introduced By: Senators Perry, Metts, Tassoni, Sosnowski, and Miller
Date Introduced: February 25, 2009
It is enacted by the General
Assembly as follows:
SECTION 1. Section 27-18-66 of the General Laws in Chapter
27-18 entitled "Accident
and Sickness Insurance Policies" is hereby amended
to read as follows:
27-18-66.
Tobacco cessation programs. -- (a) 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 2010, 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.
FDA approved smoking cessation medications.
(b) 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 smoking
cessation medication when used in accordance with FDA approval,
for not more than two (2) courses of medication of up to
fourteen (14) weeks each, annually,
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)
sixteen (16)
one-half (1/2) hour evidence based smoking cessation counseling sessions
provided
by a qualified practitioner for each covered individual.
Smoking cessation treatment may be
further defined redefined
through regulation promulgated by the health insurance commissioner.,
in accordance with the most current clinical practice
guidelines sponsored by the
department of health and human services or its component
agencies.
(c) 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.
(d) This section shall
not apply to insurance coverage providing benefits for:
(1) Hospital
confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare
supplement;
(6) Limited benefit
health;
(7) Specified disease
indemnity;
(8) Sickness or bodily
injury or death by accident or both; and
(9) Other limited
benefit policies.
SECTION 2. Section 27-19-57 of the General Laws in
Chapter 27-19 entitled "Nonprofit
Hospital Service
Corporations" is hereby amended to read as follows:
27-19-57.
Tobacco cessation programs. -- (a) 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 2010, 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
FDA approved smoking cessation medications.
(b) 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 smoking
cessation medication, when used in accordance with FDA
approval, for not more than two (2)
courses of medication of up to fourteen (14) weeks each,
annually, 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)
sixteen (16)
one-half (1/2) hour evidence based smoking cessation counseling sessions
provided
by a qualified practitioner for each covered individual.
Smoking cessation treatment may be
further defined redefined
through regulation promulgated by the health insurance commissioner
in accordance with the most current clinical practice
guidelines sponsored by the
department of health and human services or its component
agencies.
(c) 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.
(d) This section shall
not apply to insurance coverage providing benefits for:
(1) Hospital
confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare
supplement;
(6) Limited benefit
health;
(7) Specified disease
indemnity;
(8) Sickness or bodily
injury or death by accident or both; and
(9) Other limited
benefit policies.
SECTION 3. Section 27-20-53 of the General Laws in Chapter
27-20 entitled "Nonprofit
Medical Service
Corporations" is hereby amended to read as follows:
27-20-53.
Tobacco cessation programs. -- (a) 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 2010, 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
FDA approved smoking cessation medications.
(b) 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) smoking cessation
medication, when used in accordance with FDA approval, for not
more than two (2) courses of
medication of up to fourteen (14) weeks each, annually, 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)
sixteen (16)
one-half (1/2) hour evidence based smoking cessation counseling sessions
provided
by a qualified practitioner for each covered individual.
Smoking cessation treatment may be
further defined redefined
through regulation promulgated by the health insurance commissioner.,
in accordance with the most current clinical practice
guidelines sponsored by the
department of health and human services or its component
agencies.
(c) 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.
(d) This section shall not
apply to insurance coverage providing benefits for:
(1) Hospital
confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare
supplement;
(6) Limited benefit
health;
(7) Specified disease
indemnity;
(8) Sickness or bodily
injury or death by accident or both; and
(9) Other limited
benefit policies.
SECTION 4. Section 27-41-70 of the General Laws in Chapter
27-41 entitled "Health
Maintenance
Organizations" is hereby amended to read as follows:
27-41-70.
Tobacco cessation programs. -- (a) 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 2010, 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.
FDA approved smoking cessation medications.
(b) 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 smoking
cessation medication, when used in accordance with FDA
approval, for not more than two (2)
courses of medication of up to fourteen (14) weeks each,
annually, 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)
sixteen (16)
one-half (1/2) hour evidence based smoking cessation counseling sessions
provided
by a qualified practitioner for each covered individual.
Smoking cessation treatment may be
further defined redefined
through regulation promulgated by the health insurance commissioner
in accordance with the most current clinical practice
guidelines sponsored by the
department of health and human services or its component
agencies.
(c) 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.
(d) This section shall not
apply to insurance coverage providing benefits for:
(1) Hospital
confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare
supplement;
(6) Limited benefit
health;
(7) Specified disease
indemnity;
(8) Sickness or bodily
injury or death by accident or both; and
(9) Other limited
benefit policies.
SECTION 5. This act shall take effect upon passage.
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LC01385/SUB A
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