SB 634 Requires insurer to provide coverage for eating disorders
Sponsor: Pearce
LR Number: 5055S.01I Fiscal Note available
Committee: Small Business, Insurance and Industry
Last Action: 2/28/2012 - Hearing Conducted S Small Business, Insurance and Industry Committee Journal Page:
Title: Calendar Position:
Effective Date: August 28, 2012

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Current Bill Summary


SB 634 - Under this act, each health carrier must provide coverage for the diagnosis and treatment of eating disorders beginning January 1, 2013. Under the terms of the act, health carriers shall not deny eligibility or continued eligibility to an individual to enroll or renew coverage under the terms of the plan solely for the purpose of avoiding the requirements of the act or deny coverage for treatment of eating disorders, including coverage for residential treatment of eating disorders, if such treatment is medically necessary in accordance with the Practice Guidelines for the Treatment of Patients with Eating Disorders.

Under the act, health carriers shall not provide monetary payments, rebates, or other benefits to individuals to encourage such individuals to accept less than the minimum protections available under the act. In addition, a health carrier shall not penalize or otherwise reduce or limit the reimbursement of a health care provider because such provider provided care to a beneficiary in accordance with this act. The eating disorder health insurance mandate requires the insurer to provide access to psychiatric and medical treatment under the plan and provide coverage for integrated care and treatments as prescribed by medical and psychiatric health care professionals, including but not limited to nutrition counseling, physical therapy, dietician services, medical monitoring, and psychiatric monitoring.

Nothing in the act shall be construed as requiring a health carrier to provide coverage of mental illness.

The provisions contained in this act are similar to ones contained in SB 229 (2011), SB 744 (2010), SB 463 (2009), and HB 519 (2009).

STEPHEN WITTE