Effective 5/14/2019
31A-22-652. Coverage for mental health services in schools.
31A-22-652. Coverage for mental health services in schools.
- (1) As used in this section, “local education agency” means:
- (a) a school district;
- (b) a charter school; or
- (c) the Utah Schools for the Deaf and the Blind.
- (2) A health benefit plan that is entered into or renewed on or after January 1, 2020, may not deny a claim for a covered mental health service solely because the mental health service is provided:
- (a) at a local education agency building or facility; or
- (b) by an employee or contractor of a local education agency.
- (3) Nothing in this section:
- (a) prohibits a health benefit plan from denying a claim:
- (i) by an individual that is not a licensed health care provider;
- (ii) by a health care provider practicing outside the health care provider’s scope of practice;
- (iii) that is submitted by a person that is not a network provider;
- (iv) for a mental health service that is not medically necessary as determined by the health benefit plan; or
- (v) that does not otherwise comply with the health benefit plan’s policies; or
- (b) requires a health benefit plan to pay a claim for a service that is:
- (i) provided under an individualized education program as defined in Section 53E-4-301; or
- (ii) administrative in nature to the local education agency.
- (a) prohibits a health benefit plan from denying a claim:
Enacted by Chapter 172, 2019 General Session
Technically renumbered to avoid duplication of section number used in SB 264, Chapter 439