2012 Rhode Island General Laws
Title 27 - Insurance
Chapter 27-38.2 - Insurance Coverage for Mental Illness and Substance Abuse
Chapter 27-38.2-2 - Definitions.

§ 27-38.2-2 Definitions. – For the purposes of this chapter, the following words and terms have the following meanings:

(1) "Health insurers" means all persons, firms, corporations, or other organizations offering and assuring health services on a prepaid or primarily expense-incurred basis, including but not limited to policies of accident or sickness insurance, as defined by chapter 18 of this title, nonprofit hospital or medical service plans, whether organized under chapter 19 or 20 of this title or under any public law or by special act of the general assembly, health maintenance organizations, or any other entity which insures or reimburses for diagnostic, therapeutic, or preventive services to a determined population on the basis of a periodic premium. Provided, this chapter does not apply to insurance coverage providing benefits for:

(i) Hospital confinement indemnity;

(ii) Disability income;

(iii) Accident only;

(iv) Long-term care;

(v) Medicare supplement;

(vi) Limited benefit health;

(vii) Specific disease indemnity;

(viii) Sickness or bodily injury or death by accident or both; and

(ix) Other limited benefit policies.

(2) "Mental illness" means any mental disorder and substance abuse disorder that is listed in the most recent revised publication or the most updated volume of either the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association or the International Classification of Disease Manual (ICO) published by the World Health Organization and that substantially limits the life activities of the person with the illness; provided, that tobacco and caffeine are excluded from the definition of "substance" for the purposes of this chapter. "Mental illness" shall not include: (i) mental retardation, (ii) learning disorders, (iii) motor skills disorders, (iv) communication disorders, and (v) mental disorders classified as "V" codes. Nothing shall preclude persons with these conditions from receiving benefits provided under this chapter for any other diagnoses covered by this chapter.

(3) "Mental illness coverage" means inpatient hospitalization, partial hospitalization provided in a hospital or any other licensed facility, intensive out patient services, outpatient services and community residential care services for substance abuse treatment. It shall not include methadone maintenance services or community residential care services for mental illnesses other than substance abuse disorders.

(4) "Outpatient services" means office visits that provide for the treatment of mental illness and substance abuse.

(5) "Community residential care services" mean those facilities as defined and licensed in accordance with chapter 24 of title 40.1.

History of Section.
(P.L. 1994, ch. 225, § 1; P.L. 1994, ch. 336, § 1; P.L. 2001, ch. 174, § 2; P.L. 2001, ch. 409, § 2.)