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

2. 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

3. 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

4. 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 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.

5. 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)

6. 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.

7. 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

8. 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

9. 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

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