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Minutes for HB2459 - Committee on Insurance

Short Title

Limiting utilization review conducted by health plans under certain circumstances involving the treatment of mental illness or substance abuse disorder.

Minutes Content for Mon, Feb 10, 2020

Chairperson Vickrey opened the hearing on HB 2459. Eileen Ma, Assistant Revisor of Statutes, provided an overview of the bill (Attachment 1).

Mark Desetti testified in support of the bill. He said suicide involved more than just teenagers. Suicide rates had also increased in police officers, veterans and military personnel, farmers, young adults and as a result of drug use. He related that Kristi Bennett, for whom the bill was named, was his son's girlfriend and he described his family's struggle to obtain treatment for his son's alcohol use (Attachment 2).

Representative Mark Samsel testified in support of the bill. He said Kansas was once the leader in mental health treatment but since being elected, many people had told him mental health care was their number 1 concern. The bill would put mental illness on par with physical ones. Rep. Samsel also elaborated on the 180-days, in-network treatment.  (Attachment 3).

Rennie Shuler-McKinney testified in support of the bill. She related her difficulties as Director of Clinical Services in obtaining mental health care for parents that came through her Shawnee Mission facility. She also described patients' extreme efforts to obtain treatment for substance abuse or suicide attempts (Attachment 4).

Becky Fast testified in support of the bill. She said social workers were the largest provider of mental health services across a variety of venues: schools, hospitals, clinics and prisons. She said licensed social workers were in short supply in rural Kansas. Despite recent federal laws meant to bring parity between mental and physical health care coverage, gaping holes remained on how mental health care costs were paid (Attachment 5).

Jennifer Cook testified in support of the bill. She was Kristi Bennett's sister, a victim of suicide. She described Kristi and their family's unsuccessful efforts to get her admitted to a health treatment facility, despite having insurance. She said their efforts failed because insurance companies imposed strict requirements on admission rather than being determined by the doctors or the insured who paid the premiums. She added that the bill would treat mental health and substance abuse the same way as physical ailments (Attachment 6).

Kyle Kessler testified in support of the bill. He said Kansas recorded 555 suicide deaths in 2018, the highest in 20 years. This was despite the federal law passed nearly a quarter century ago on mental health parity. The difficulties in finding guidance to access the care needed only compounded the challenges someone with a mental illness faced.(Attachment 7)

Tim DeWeese testified in support of the bill. He referred the committee to his written testimony (Attachment 8).

Derek Hein testified in support of the bill (Attachment 9).

Amy Campbell testified in support of the bill. She said the Mental Health Coalition found through research at national and state levels that despite federal and state parity laws, policyholders often encountered barriers to behavioral health treatment from their insurance provider and those barriers were devastating (Attachment 10).

Jane Sharp testified in support of the bill. She said in the 30 years she has worked as a licensed psychologist she experienced difficulties in getting mental health care for patients when insurance companies claimed the patient did not meet the criteria and declined admission. She said that left insurance companies making clinical decisions that should be left to mental health care providers (Attachment 11)

Joni Breidenthal testified in support of the bill. She said her 24-year-old son died by suicide. She said it was a result of childhood trauma that left him broke, desperate, addicted and suicidal. Accessing mental health services for him was "hell" and "ginormous" barriers stood in the way. She explained unqualified insurance companies were making life and death decisions for children, young adults and family members of a person with mental illness. She provided names of other suicide victims in her written testimony (Attachment 12).

Chris Goetz testified in support of the bill. He said the bill was a matter of human life. He described how as a pastor people came to him with major struggles: abuse, addiction, marital problems, etc. He said the difficulty in obtaining mental health care was not with the hospitals, but instead with a man or woman with a business degree who had a say over a doctor with years of specialized training in determining the best way to treat a person (Attachment 13).

Dr. Dena Hubbard provided written testimony in support of the bill (Attachment 14).

Stuart Little provided written testimony in support of the bill (Attachment 15).

Dennis Kriesel provided written testimony in support of the bill (Attachment 16).

Rachel Brown provided written testimony in support of the bill (Attachment 17).

Bob MacDougall provided written testimony in support of the bill (Attachment 18).

Leslie Thacker provided written testimony in support of the bill (Attachment 19).

Jessica Murphy provided written testimony in support of the bill (Attachment 20).

Donn Teske provided written testimony in support of the bill (Attachment 21).

Jeff Dodson provided written testimony in support of the bill (Attachment 22).

Andrea Spieker provided written testimony in support of the bill (Attachment 23).

Jamie Nellans provided written testimony in support of the bill (Attachment 24).

Nikki Green provided written testimony in support of the bill (Attachment 25).

Chris and Marie Lenquist provided written testimony in support of the bill (Attachment 26).

Bonnie Swade provided written testimony in support of the bill (Attachment 27).

Chad Austin provided written testimony in support of the bill (Attachment 28).

Katherine Milton provided written testimony in support of the bill (Attachment 29).

Robyn Chadwick provided written testimony in support of the bill (Attachment 30).

Dr. Bethany Randles provided written testimony in support of the bill (Attachment 31)

Halie Brockus provided written testimony in support of the bill (Attachment 32).

The members questioned the proponent conferees including: The percentage of people that could be helped during crises stabilization if the bill passed, how the mental health systems in Kansas compared to other states and what other states were doing regarding mental health parity.

Brad Smoot testified in opposition to the bill. He respectfully suggested the committee do the "right something" not just something that would create unnecessary costs or unintended results. He described how Kansans would be affected by this government mandate and provided a chart showing sources of health insurance. He added that more and more companies were choosing to be self-insured to avoid mandates (Attachment 33).

Kristi Brown testified in opposition to the bill. She said they supported efforts to provide Kansans with the ability to access healthcare insurance options to best fit their needs but that any type of mandate would cause increased costs to the insured and could eliminate an insurer's ability to appropriately manage cases (Attachment 34).

William Sneed testified in opposition to the bill. He said they agreed that patients seeking care for behavioral health conditions had unique needs that required immediate intervention; however, the bill had the potential to increase costs and removed the ability of health insurance providers to address fraud, waste and abuse (Attachment 35).

Nicholas Reinecker testified in opposition to the bill. He provided Powerpoint slides concerning behavioral health and the Controlled Substances Act for the purpose of identifying alternative solutions and recommendations for improvement (Attachment 36).

Larrie Ann Brown provided written testimony in opposition to the bill (Attachment 37).

Jay McLaren provided written testimony in opposition to the bill (Attachment 38).

Beverly Gossard, provided written testimony in opposition of the bill (Attachment 39).

The members questioned the opponent conferees including: whether there was another path to addressing mental health care, if the opponents were willing to work with the committee to resolve issues, if there were legal requirements for insurers related to mental health and other health problems, if there were exceptions for emergencies and the definition of a mental health emergency.

There being no other conferees or questions, Chairperson Vickrey closed the hearing on HB 2459.

The meeting was adjourned at 5:25 PM.