Chris Rizo Apr. 11, 2008, 5:28pm
AUSTIN (Legal Newsline)-Texas Attorney General Greg Abbott has been asked for a legal opinion on whether a group health plan is required to provide the same number of outpatient visits for mental illnesses and physical illnesses.
The request was made by state Sen. Rodney Ellis, D-Houston, who sponsored legislation in 1997 that required group health insurance coverage for mental conditions, such as depression, bi-polar disorder and schizophrenia.
The law, outlined in HB 1173, also required that serious mental illnesses and physical illnesses be treated equally with regard to amount limitations, deductibles, co-payments and co-insurance factors.
Under the law, group health plans are required to provide no less than 60 outpatient visits for the treatment of serious mental illnesses.
The statute also says outpatient mental health visits must be covered "under the same terms" as outpatient visits for physical illnesses.
In a letter to Abbott, the senator said the Texas Department of Insurance is not treating physical conditions the same as mental conditions.
The law, he said "appears to clearly require group health plans that provide more than 60 outpatient visits for physical illnesses to provide the same number of visits for serious mental illnesses."
He said the Department of Insurance is interpreting the law differently, and wants an opinion by the attorney general to help clarify the statute.
From Legal Newsline: Reach reporter Chris Rizo by e-mail at firstname.lastname@example.org.