_______________________________________________
SENATE
BILL 6129
_______________________________________________
AS AMENDED BY
THE HOUSE
Passed Legislature -
1996 Regular Session
State of Washington 54th
Legislature 1996 Regular Session
By
Read first time 01/08/96.
Referred to Committee on Health & Long‑Term Care.
Allowing a
mental health practitioner and an enrollee to contract for services under
certain circumstances.
AN ACT Relating to
mental health services; and adding a new section to chapter 48.43 RCW.
BE IT ENACTED BY THE
LEGISLATURE OF THE STATE OF WASHINGTON:
NEW SECTION. Sec.
1. A new section is added
to chapter 48.43 RCW to read as follows:
(1) For purposes of
this section:
(a) "Health
carrier" includes disability insurers regulated under chapter 48.20 or
48.21 RCW, health care services contractors regulated under chapter 48.44 RCW,
plans operating under the health care authority under chapter 41.05 RCW, the
basic health plan operating under chapter 70.47 RCW, the state health insurance
pool operating under chapter 48.41 RCW, insuring entities regulated under this
chapter, and health maintenance organizations regulated under chapter 48.46
RCW.
(b)
"Intermediary" means a person duly authorized to negotiate and
execute provider contracts with health carriers on behalf of mental health care
practitioners.
(c) Consistent with their
lawful scopes of practice, "mental health care practitioners"
includes only the following: Any generally recognized medical specialty of
practitioners licensed under chapter 18.57 or 18.71 RCW who provide mental
health services, advanced practice psychiatric nurses as authorized by the
nursing care quality assurance commission under chapter 18.79 RCW,
psychologists licensed under chapter 18.83 RCW, social workers, marriage and
family therapists, and mental health counselors certified under chapter 18.19
RCW.
(d) "Mental health
services" means outpatient services.
(2) Consistent with
federal and state law and rule, no contract between a mental health care
practitioner and an intermediary or between a mental health care practitioner
and a health carrier that is written, amended, or renewed after the effective
date of this section may contain a provision prohibiting a practitioner and an
enrollee from agreeing to contract for services solely at the expense of the
enrollee as follows:
(a) On the exhaustion
of the enrollee's mental health care coverage;
(b) During an appeal or
an adverse certification process;
(c) When an enrollee's
condition is excluded from coverage; or
(d) For any other
clinically appropriate reason at any time.
(3) If a mental health
care practitioner provides services to an enrollee during an appeal or adverse
certification process, the practitioner must provide to the enrollee written
notification that the enrollee is responsible for payment of these services,
unless the health carrier elects to pay for services provided.
(4) This
section does not apply to a mental health care practitioner who is employed
full time on the staff of a health carrier.
Passed
the Senate March 2, 1996.
Passed
the House February 28, 1996.
Approved by the Governor March 30, 1996.
Filed in
Office of Secretary of State March 30, 1996.
