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ACT NO. 129

(H.628)

Health Insurance Coverage for Mental Health and Substance Abuse Services

This act requires that on or before March 1 of each year, each of the five largest health insurance companies in Vermont file a report card on its health insurance plan’s performance in relation to quality measures for the care, treatment, and treatment options of mental health and substance abuse conditions covered under the plan. The act identifies specific elements to be included in the report card.

In addition, this act requires that each of the health insurance companies file the health insurance plan’s revenue loss and expense ratio relating to the care and treatment of mental health conditions covered under its health insurance plan. The expense ratio report shall list amounts paid in claims for services and administrative costs separately. This portion of the act is repealed on July 1, 2003.

This act directs that on or before January 15, 2001, 2002, and 2003, the Agency of Human Services report the Medicaid program expenditures for behavioral health services to the Committees on Health and Welfare of the Senate and House of Representatives.

This act establishes a task force to develop performance quality measures and address oversight issues for managed behavioral health care organizations. This act requires that the task force report on activities and recommendations to the Committees on Health and Welfare of the Senate and House of Representatives on or before Decem-ber 1 of each year. This act identifies specific stakeholders to serve on the task force.

This act establishes that a custodian of medical records may impose a charge that is no more than a flat $5.00 fee or no more than $0.50 per page, whichever is greater, for providing copies of an individual’s health care record. This act allows a custodian to charge a reasonable fee for providing copies of x-rays, models, disks, tapes, or other health care record information maintained in other formats. This act provides a definition of “custodian”, “health care record”, and “individual” applicable to this act.

This act directs the Commissioner of Banking, Insurance, Securities, and Health Care Administration to report to the legislature on or before December 1, 2000 with a comprehensive survey of and recommendations concerning the options for legislative, administrative, and other non-judicial mechanisms to enhance the accountability of health insurance plans for decisions on coverage of medically necessary care to beneficiaries.

Effective Date: July 1, 2000