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2019 New Hampshire Revised Statutes
Title XXXVII - Insurance
Chapter 417-E - Coverage for Certain Biologically-Based Mental Illnesses
Section 417-E:1 - Coverage for Certain Biologically-Based Mental Illnesses.
Universal Citation: NH Rev Stat § 417-E:1 (2019)
417-E:1 Coverage for Certain Biologically-Based Mental Illnesses. –
I. For the purposes of this chapter "mental illness" means a clinically significant or psychological syndrome or pattern that occurs in a person and that is associated with present distress, a painful symptom or disability, impairment in one or more important areas of functioning, or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.
II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.
II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.
III. The following mental illnesses, as defined in the most current edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders published by the American Psychiatric Association, shall be covered under this section:
(a) Schizophrenia and other psychotic disorders.
(b) Schizoaffective disorder.
(c) Major depressive disorder.
(d) Bipolar disorder.
(e) Anorexia nervosa and bulimia nervosa.
(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders, when treatment, including the use of intravenous immunoglobulin therapy, is ordered by a physician.
(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders.
(g) Panic disorder.
(h) Pervasive developmental disorder or autism.
(i) Chronic post-traumatic stress disorder.
IV. The benefits required under this section shall begin when benefits provided under RSA 415:18-a and RSA 420-B:8-b, as applicable are exhausted.
V. The commissioner may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Mental Health Parity Act of 2008 that relate to the business of insurance.
V. The commissioner shall have the authority to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Act), including any amendments thereto and any federal rules adopted thereunder, and may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Act that relate to the business of insurance.
V-a. Under examination authority in RSA 400-A:37, the commissioner shall periodically examine and evaluate health insurers, health service corporations, and health maintenance organizations for compliance with this chapter and with the Act. Such examination and evaluation shall include provider reimbursement practices. The result of such examinations and evaluations shall be made public to the fullest extent allowed under RSA 400-A:37.
VI. Nothing in this section shall be construed to affect any obligation to provide services to an individual under an individualized family service plan or an individualized education program, as required under the federal Individuals With Disabilities Education Act, the state children's health insurance program authorized by 42 U.S.C. section 1397aa et seq., or the provision of services to an individual under any other federal or state law.
I. For the purposes of this chapter "mental illness" means a clinically significant or psychological syndrome or pattern that occurs in a person and that is associated with present distress, a painful symptom or disability, impairment in one or more important areas of functioning, or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.
[Paragraph II effective until January 1, 2020; see also paragraph II set out below.]
II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.
[Paragraph II effective January 1, 2020; see also paragraph II set out above.]
II. Notwithstanding any other provision of law, each insurer that issues or renews any policy of accident or health insurance and each nonprofit health service corporation under RSA 420-A and health maintenance organization under RSA 420-B providing benefits for disease or sickness in the state of New Hampshire shall provide benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness.
III. The following mental illnesses, as defined in the most current edition of the Diagnostic and Statistical Manual (DSM) of Mental Disorders published by the American Psychiatric Association, shall be covered under this section:
(a) Schizophrenia and other psychotic disorders.
(b) Schizoaffective disorder.
(c) Major depressive disorder.
(d) Bipolar disorder.
(e) Anorexia nervosa and bulimia nervosa.
[Paragraph III(f) effective until July 1, 2024; see also paragraph III(f) set out below.]
(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders, when treatment, including the use of intravenous immunoglobulin therapy, is ordered by a physician.
[Paragraph III(f) effective July 1, 2024; see also paragraph III(f) set out above.]
(f) Obsessive-compulsive disorder, including pediatric autoimmune neuropsychiatric disorders.
(g) Panic disorder.
(h) Pervasive developmental disorder or autism.
(i) Chronic post-traumatic stress disorder.
IV. The benefits required under this section shall begin when benefits provided under RSA 415:18-a and RSA 420-B:8-b, as applicable are exhausted.
[Paragraph V effective until January 1, 2020; see also paragraph V set out below.]
V. The commissioner may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Mental Health Parity Act of 2008 that relate to the business of insurance.
[Paragraph V effective January 1, 2020; see also paragraph V set out above.]
V. The commissioner shall have the authority to enforce the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Act), including any amendments thereto and any federal rules adopted thereunder, and may adopt rules, under RSA 541-A, as may be necessary to effectuate any provisions of the Act that relate to the business of insurance.
[Paragraph V-a effective January 1, 2020.]
V-a. Under examination authority in RSA 400-A:37, the commissioner shall periodically examine and evaluate health insurers, health service corporations, and health maintenance organizations for compliance with this chapter and with the Act. Such examination and evaluation shall include provider reimbursement practices. The result of such examinations and evaluations shall be made public to the fullest extent allowed under RSA 400-A:37.
VI. Nothing in this section shall be construed to affect any obligation to provide services to an individual under an individualized family service plan or an individualized education program, as required under the federal Individuals With Disabilities Education Act, the state children's health insurance program authorized by 42 U.S.C. section 1397aa et seq., or the provision of services to an individual under any other federal or state law.
Source. 1994, 298:1. 1997, 190:13, 14. 2002, 204:3. 2009, 235:8. 2010, 188:13; 363:1. 2011, 224:282, eff. July 1, 2011. 2019, 277:1, 2, eff. Sept. 17, 2019; 277:3, eff. July 1, 2024; 283:1, 2, eff. Jan. 1, 2020.
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