31A-22-652. Coverage for mental health services in schools.

243 words·~1 min read·/ut/title-31a/chapter-22/31a-22-652

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Effective 5/14/2019

(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.

Enacted by Chapter 172 , 2019 General Session

Technically renumbered to avoid duplication of section number used in SB 264, Chapter 439