SB 463 Requires health carriers to provide coverage for the treatment and diagnosis of eating disorders
Sponsor: Days Co-Sponsor(s)
LR Number: 1745S.01I Fiscal Note: 1745-01
Committee: Small Business, Insurance and Industry
Last Action: 3/24/2009 - Hearing Conducted S Small Business, Insurance and Industry Committee Journal Page:
Title: Calendar Position:
Effective Date: August 28, 2009

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Current Bill Summary


SB 463 - This act requires health carriers to provide coverage for the treatment and diagnosis of eating disorders. The coverage shall apply to health benefit plans issued, continued or renewed on or after January 1, 2010. Under the act, a health carrier offering group health insurance coverage shall not cancel or refuse to renew an individual’s coverage for the purpose of avoiding the eating disorder mandate. The carrier shall not deny coverage for the treatment of eating disorders, including coverage for residential treatment of eating disorders, if such treatment is medically necessary in accordance with certain national standards. Under this act, a health carrier shall not provide payments or other benefits to individuals to encourage them to accept less coverage than is provided by the act. A health carrier shall not penalize, reduce or limit the reimbursement to a provider because the provider provided care to a beneficiary in accordance with the act.

Under the act, the mandated coverage shall include access to psychiatric and medical treatment. The health benefit plan shall also provide coverage for integrated care and treatments as prescribed by medical and psychiatric health care professionals.

The coverage mandated by the act for treating and diagnosing eating disorders does not include coverage for mental illness.

The coverage required by the act shall not be subject to any greater deductible or co-payment than other health care services provided by the plan.

The act requires the Department of Health and Senior Services, in collaboration with the Department of Social Services, to provide diagnosis and treatment services for Missouri residents who do not have insurance coverage for eating disorders. The eating disorder care shall be provided at eating disorder units, private facilities, and state-operated facilities that have licensed eating disorder specialists on staff.

This act is identical to HB 519 (2009).

STEPHEN WITTE