SS#2/SCS/HB 191 - This act requires coverage of certain cancer examinations and mental health services, modifies the law regarding the disclosure of HIV status, and requires the disclosure of breast implantation information.

HIV - Court authorization is required to release a person's HIV status to peace officers, the Attorney General or any assistant attorneys general, or prosecuting attorneys. A compelling need, clear and imminent danger to an individual or to public health, or lawful entitlement to the information must be shown. Upon receipt of the application for disclosure, the court must ensure that all forms associated with the application are sealed, except for those necessary to the proceeding. Notice and response procedures are allowed, except in cases where an immediate court order is required due to clear and imminent danger, which is defined in subsection 5 of this section. This provision is substantially similar to SB 477 and HB 271.

MENTAL HEALTH INSURANCE - The Mental Health and Chemical Dependency Insurance Act is also established. A policy providing coverage for mental illness benefits shall not establish any rates, terms, or conditions that place a greater financial burden on the insured than for physical illnesses. The policy may, however, establish different deductibles, copayments or coinsurance terms than those for physical illnesses. The deductibles, copayments, or coinsurance amounts shall not be unreasonable in relation to the cost of the services provided. The insurer may also apply different limits for services rendered by schools or halfway houses, custodial care, and other services which are not medically necessary nor clinically appropriate. The mental health coverages provided by the policies may be administered by a managed care program. This provision is substantially similar to SB 338.

This act limits coverage for a specific set of severe mental disorders which are contained in the International Classification of Diseases. An employer may receive a waiver if the employer demonstrates to the director of the Department of Insurance that compliance with this act has resulted in a two percent increase in premium costs.

Every health insurance carrier is required to use standard benefit information when a claim is paid or denied or when referrals are given. This provision is substantially similar to SB 338.

CANCER SCREENING - Certain individual and group health insurance policies must provide coverage for pelvic, prostate, and colorectal examinations. All services must be performed in accordance with the American Cancer Society guidelines. This section does not apply to accident-only, hospital indemnity, Medicare supplement, long-term care, or other limited benefit health insurance policies. This provision is substantially similar to SB 181.

BREAST IMPLANTS - Physicians must inform breast implantation patients of the risks and advantages involved with the surgery. Patients must be given this information at least five days before the operation. By January 1, 2000, the Department of Health must make available a standardized written summary regarding breast implantation to all physicians, hospitals, and clinics that perform the surgery. The patient must sign an acknowledgment of receipt of the summary. This provision is substantially similar to SB 138.

OTHER - The Health Insurance Advisory Committee is created to advise the Department of Insurance on health insurance issues.

The provisions relating to mental health insurance will expire on January 1, 2005.
ERIN MOTLEY