MENTAL HEALTH LEGISLATION Jacqueline Hudson, Director of Advocacy, NAMI St. Louis March 21, 2018

Agenda Priority Mental Health Legislation: HB 2384: enhances mental health care coverage in insurance plans HB 2233: increases access to APRNs in Community Behavioral Health Centers HB 2127: increases access to Assistant Physicians (APs) in Community Behavioral Health Centers HB 10: Department of Mental Health Budget

HB 2384: Enhances Current State Mental Health Parity Law What is Mental Health Parity (also referred to as Behavioral Health Parity) Insurance benefits for mental health and substance use disorders = Coverage for other types of healthcare

Why is Parity Needed? People often have more difficulty getting behavioral health treatment than they do getting other medical care. State Law does not include chemical dependency According to a 2017-18 on-line survey conducted by the Missouri Federation of Behavioral Health Advocates, behavioral health provider networks in Missouri were found to be so limited that health plan beneficiaries had difficulty finding in-network help. When an out of network provider was available, beneficiaries encountered greater out of pocket costs, often placing care out of reach.

HB 2384: Mental Health Parity What HB 2384 Does Allows for coverage of substance use disorder (SUD) under behavioral health plan benefits, making it a necessary tool to fight MO’s opioid crisis Treats behavioral health services/treatments the same as all other health services/treatments Stipulates that treatment limitations be no more restrictive than that of other medical procedures, treatments, or surgeries (i.e. prior authorization or medical necessity review)

HB 2384: Mental Health Parity What HB 2384 Doesn’t Do Require exorbitant costs to implement – federal law permits that if insurance premiums increase by more than 2% for behavioral health coverage, that coverage can then be excluded. To date, no such exclusion has been needed nationwide Mandate insurance carriers to provide coverage for any health benefits that aren’t currently required to be covered under federal law.

HB 2384: Mental Health Parity Sponsor: Rep. Jay Barnes Senate Bill filed by Sen. David Sater (SB 1098) Passed Health and Mental Health Policy Committee 7-1 In House Rules – Administrative Oversight Committee

HB 2233: APRNs Passed out of House Committee, waiting to be put on calendar Allows CCBHCs to be included with rural health clinics in 28-day/year waiver of geographic proximity requirements Increases the number of collaborating APRNs from 3 to 5 if they provide behavioral health services We would also like it to prescribe products containing buprenorphine for up to a 30-day supply without refill

HB 2127: Assistant Physicians (AP) Passed out of House Committees Allows for reimbursement for services provided equal to that of a Physician Assistant (PA) Stipulates that a physician must practice at the same location as the AP, but not physically present while that AP provides healthcare services Changes current buprenorphine prescribing requirements (5-day without refill) to up to 30 days without refill

HB 10: Department of Mental Health Budget Hold the line on provider reimbursement rates ensuring access to treatment statewide