MISSISSIPPI LEGISLATURE
2016 Regular Session
To: Insurance
By: Representative Arnold (By Request)
AN ACT TO REQUIRE THAT HEALTH INSURANCE POLICIES AND CONTRACTS SHALL PROVIDE COVERAGE WITHOUT LIMITATION FOR PERSONS AFFECTED BY CHIARI MALFORMATION; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. (1) All individual and group health insurance policies providing coverage on an expense-incurred basis, individual and group service or indemnity type contracts issued by a nonprofit corporation, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description that are delivered, issued for delivery, continued or renewed on or after July 1, 2016, and providing coverage to any resident of this state shall provide benefits or coverage for persons affected by Chiari Malformation. The coverage for Chiari Malformation shall have no maximum amount of benefits. The coverage required under this section shall meet the requirements set forth in subsection (2) of this section.
(2) An individual shall not be required to pay an additional deductible or coinsurance for healthcare services or procedures caused by Chiari Malformation that is greater than an annual deductible or coinsurance established for similar benefits. If the program or contract does not cover a similar benefit, a deductible or coinsurance may not be set at a level that materially diminishes the value of the healthcare services or procedures. Reimbursement to health care providers for Chiari Malformation healthcare services or procedures provided under this section shall be equal to or greater than reimbursement to health care providers provided under Title XVII of the Social Security Act (Medicare).
(3) If a plan or issuer refers an individual to a nonparticipating health care provider in accordance with this section, healthcare services, procedures or other treatment due to Chiari Malformation, if any, shall be provided at no additional cost to the individual beyond what the individual would otherwise pay for services, procedures or other treatment received by a participating health care provider.
SECTION 2. This act shall take effect and be in force from and after July 1, 2016.