Mental Health Parity in the States

2007

State	Statute/Code Citation	Relevant Bills	Covered Population *	Benefit	Policies	Exclusions
Alabama	Code of AL §§27-54-1 to 27-54-7 (G/I) (2000) §10-4-115 (health care service plans) (2002) §27-21A-23 (HMOs) (2002)	2000: HB 677 2002: SB 293	Full Coverage Mental illness: schizophrenia, schizophrenia form disorder, schizoaffective disorder, bipolar disorder, panic disorder, obsessive-compulsive disorder, major depressive disorder, anxiety disorders, mood disorders, and any condition or disorder involving mental illness, excluding alcohol and substance abuse that falls under mental disorders listed in the ICD^†.	Mandated Offering Coverage for the treatment and diagnosis of mental illnesses under terms and conditions that are no less extensive than the benefits provided for medical treatment for physical illnesses. Provisions for maximum benefits and coinsurance and limitations, deductibles, exclusions, and utilization review protocols must be consistent with the chapter.	Group, Individual, HMOs and health care service plans	Group health plans covering 50 or fewer employees
Alaska	No Parity Law
Arizona	AZ Rev. Stat. Ann. 20-2322 (1997)		Coverage Defined by Plan Mental Illness	Mandated if Offered Parity in aggregate annual and aggregate lifetime limits; co-payments, limits on the number of visits or days, and medical necessity criteria may be different	Group	Businesses with 50 or fewer employees; cost increase of 1% or more
Arkansas	AR Stat. §§23-99-501 to 511 (1997)	HB 1525/ Act 1020 of 1997	Full Coverage Mental Illness and Developmental Disorders: Illnesses and disorders listed in the ICD and the DSM^††.	Mandate (Group) No differences (compared to benefits for other medical illnesses) with regard to duration or frequency of coverage, the dollar amount of coverage, or financial requirements. Mandated Offering (Individual, small insurers) Same coverage as above	Group Individual, plans for small insurers	State employees, and businesses that anticipate a cost increase of more than 1.5%
California	CA Ins. Code § 10125 (1973)		Coverage Defined by Plan Mental and nervous disorders	Mandated offering	Group	n/a
	CA Ins. Code § 10144.5 (1999)	1999: AB 88	Limited Coverage Severe mental illness: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorders, panic disorder, obsessive-compulsive disorder, pervasive developmental disorder, anorexia nervosa, bulimia nervosa. Children with one or more mental disorders other than a primary substance abuse disorder or developmental disorder.	Mandate Coverage includes OP services, IP hospital services, partial hospital services, and prescription drugs, if the policy or contract includes coverage for prescription drugs. Parity extends to maximum lifetime benefits, co-payments and coinsurance and individual and family deductibles.	Group, individual, HMO	n/a
Colorado	CO Rev. Stat. §§10-16-104(5-5.5) (1992, 1997)	1997: HB 1192 2003: HB 1164	Coverage Defined by Plan Mental illness excluding autism Limited Coverage Biologically-based mental illness, including schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, and obsessive compulsive disorder.	Mandate 45 IP days or 90 days of partial hospitalization. $1,000 or 20 OP visits. Co-payments and coinsurance may be different but cannot exceed 50% of the payment. Deductibles may not differ from those for other conditions Mandate (biologically based) Coverage must be no less extensive than coverage for physical illness.	Group	Small employers providing coverage through a basic health benefit plan
	§101-16-104.7 (Substance Abuse) (2002)	2002: HB 1263/Ch. 208 of 2002	Substance abuse	Mandated If Offered Plan must cover voluntary or court-ordered treatment	Group and individual	n/a
Connecticut	CT Gen. Stat. § 38a-488a and § 38a-514 (1999)	1999: HB 7032	Broad Coverage All mental illnesses recognized by the most recent edition of the DSM, including addictive disorders. Exceptions: mental retardation, learning disorders, motor skills disorders, communication disorders, caffeine-related disorders, relational problems and “additional conditions that may be the focus of clinical attention, that are not otherwise defined as mental disorders in the most recent addition” of the DSM.	Mandate There may not be any terms, conditions or benefits that place a greater financial burden on an insured for access to diagnosis or treatment of mental or nervous conditions than for diagnosis or treatment of medical, surgical or other physical health conditions.	Group and individual	n/a
Delaware	DE Code Ann. Tit. 18 § 3343 (1998, 2001)	1998: HB 156 2001: HB 100	Limited Coverage Serious mental illness: schizophrenia, bipolar disorder, obsessive-compulsive disorder, major depressive disorder, panic disorder, anorexia nervosa, bulimia nervosa, schizoaffective disorder and delusional disorder. Drug and alcohol dependencies included in 2001.	Mandate Coverage required under the same terms and conditions of coverage offered for physical illnesses. No out of network coverage, benefit management may be different than for physical illnesses.	Group, individual, and HMO	n/a
District of Columbia	DC ST § 31-3104 (1999, 2006) Select “Update” at top of section		Full Coverage Clinically significant mental illness: any psychiatric disease identified in the most recent edition of the ICD or the DSM. Substance abuse included.	Mandate Minimum benefits: 60 IP days; minimum rate of 75% for the first 40 OP visits and a minimum rate of 60% for any OP visits thereafter.	Group and individual	n/a
Florida	FL Stat. § 627.668		Full Coverage Mental and nervous disorders as defined in the standard nomenclature of the American Psychiatric Association	Mandated Offering Benefits (durational limits and dollar amounts) do not need to be the same as those for physical illness once minimum benefits are met. Minimum benefits: 30 IP (including partial hospitalization) days and $1,000 in OP benefits	Group and HMO	n/a
Georgia	GA Code §33-24-29 (Group- small employers) §33-24-29.1 (Group- large employers) §33-24-28.1 (Individual) (1998)	1998: SB 620	Full Coverage Mental disorders as defined by the DSM or the ICD, “or as the Commissioner may further define such term by rule and regulation. Substance abuse included.	Mandated Offering Group- small: Same degree of coverage and lifetime and annual dollar limits compared to physical illness. Co-pays and co-insurance must also be equal, but IP days and OP visits may be different. Separate deductibles and out-of-pocket maximums may be applied, but cannot be greater than those for medical/surgical benefits Group- large: Same degree of coverage and lifetime and annual dollar limits compared to physical illness. Co-pays, co-insurance, and visit limits must also be equal Individual: Insurers not required to pay beyond 30 IP days and 48 OP visits. Exclusions, reductions, or other limitations as to coverages, deductibles, or coinsurance must also apply to similar benefits.	Group, individual and HMO	n/a
Hawaii	HI Rev. Stat. §431M to §431M-7 (1988, 1999, 2003, 2005)	1999: SB 844 2003: SB 1321 2005: SB 761	Broad Coverage Mental illness: a syndrome of clinically significant psychological, biological, or behavioral abnormalities that results in personal distress or suffering, impairment of capacity for functioning, or both. Does not include epilepsy, senility, mental retardation or other developmental disabilities. Limited Coverage Serious mental illness: a mental disorder consisting of at least one of the following:  schizophrenia, schizo-affective disorder, bipolar types I and II, delusional disorder, major depression, obsessive compulsive disorder, and dissociative disorder as defined in the most recent version of the DSM and which is of sufficient severity to result in substantial interference with the activities of daily living. Substance abuse included in a separate section.	Mandate Mental illness: Deductibles and co-payments must be equal to those for physical illnesses requiring a comparable level of care. Minimum requirements: 30 IP days, partial hospitalization/day treatment at least 30 visits per year.  OP services for SA and MH: at least 24 per year.  At least 12 of those 24 visits must be for MH, not SA.  At least 2 treatment episodes for SA treatment per lifetime. Serious mental illness: rates, terms, or conditions including service limits and financial requirements must be equal to those for medical/surgical conditions.	Group, individual, and HMO	Businesses with 25 or fewer employees
Idaho	ID Stat.: §67-5761A	2006: H.B. 615	Limited Coverage Serious mental illness and serious emotional disturbances: Schizophrenia, Paranoia and other psychotic disorders, Bipolar disorders (mixed, manic, and depressive), Major depressive disorders (single episode or recurrent), Schizoaffective disorders (bipolar or depressive), Panic disorders, and Obsessive-Compulsive disorders.	Mandate Services must be provided in a manner that: is not more restrictive or more generous than benefits and coverages provided for other major illnesses; provides clinical care, but does not require partial care, of serious mental illness or serious emotional disturbance; and is consistent with effective and common methods of controlling health care costs for other major illnesses.	Group, State employees only	n/a
Illinois	IL Rev. Stat. Ch. 215 Art. XX §5/370c (2^nd version listed) (1991, 2001, 2005)	2001: P.A. 092-0185 2005: P.A. 094-0584 2005: P.A. 094-0906 2005: P.A. 094-921	Coverage Defined by Plan Mental, emotional, or nervous disorders Limited Coverage Serious Mental Illness: schizophrenia; paranoia and other psychotic disorders; bipolar disorders (hypomanic, manic, depressive, and mixed); major depressive disorders (single episode or recurrent); schizoaffective disorder (bipolar or depressive); pervasive developmental disorders; obsessive-compulsive disorders, depression in childhood and adolescence; panic disorder; post-traumatic stress disorder (acute, chronic, or with delayed-onset)	Mandated Offering The insured may be required to pay up to 50% of expenses incurred as a result of the treatment or services, and the annual benefit limit may be limited to the lesser of $10,000 or 25% of the lifetime policy limit. Mandate (SMI) The coverage must provide for same durational limits, amount limits, deductibles, and co‑insurance requirements for serious mental illness as are provided for other illnesses and diseases. Minimum of: 45 IP days and 60 OP visits.	Group and HMOs	Businesses with 50 or fewer employees
Indiana	IN Code § 27-13-7-14.8 (1999, 2001)	1999: HB 1108 2001: HB 1001 2003: HB 1135	Coverage Defined by Plan Mental illness. “Services for mental illnesses” as defined by a contract, policy, or plan for health services. Substance abuse treatment for those with mental illnesses added in 2001.	Mandated if Offered Treatment limitations and financial requirements must be equal to medical and surgical conditions.	Group, individual	Businesses with 50 or fewer employees, or a cost increase of 4% or more
	IN Code § 5-10-8-9 (State Employee Plan, 1997)		Coverage Defined by Plan Mental illness. “Services for mental illnesses” as defined by a contract, policy, or plan for health services. Substance abuse treatment for those with mental illnesses included.	Mandated if Offered Treatment limitations and financial requirements must be equal to medical and surgical conditions.	State employees	Cost increase of 4% or more
Iowa	IA Code 514C.22 (2005)	2005: HB 420 (Under HF 420)	Limited Coverage Biologically based mental illness: schizophrenia, bipolar disorders, major depressive disorders, schizo-affective disorders, obsessive- compulsive disorders, pervasive developmental disorders, and autistic disorder	Mandate Annual and lifetime limits as well as deductibles, coinsurance and co-payments must be equal those for medical/surgical coverage. At minimum, a plan must provide 30 IP days and 52 OP visits.	Group	Businesses with 50 or fewer employees
Kansas	KS Stat. 40-2,105 (1998, 2001, 2003)	2001: HB 2033	Full Coverage Alcoholism, drug use, mental or nervous conditions. “Nervous or mental conditions" refers to disorders specified in the DSM.	Mandate Minimum benefits: 30 IP days and reimbursement for treatment at: 100% of the first $100, 80% of the next $100, and 50% of the next $1,640 in a year, and $7,500 in a lifetime.	Group, individual, HMO, state employees	High deductible plans
Kentucky	KY Rev. Stat. §§ 304.17A.660-669 (2000, 2002)	2000: HB 268	Full Coverage Mental health condition: any condition or disorder that involves mental illness or alcohol and other drug abuse that falls under any of the diagnostic categories listed in the DSM or that is listed in the mental disorders section of the ICD.	Mandated if Offered Coverage for mental health conditions must be under the same terms and conditions as coverage for physical health conditions. “Terms and conditions”: day or visit limits, episodes of care, any lifetime or annual payment limits, deductibles, co-payments, prescription coverage, coinsurance, out-of-pocket limits, and any other cost-sharing requirements.	Group	Plans covering 51 or fewer employees
Louisiana	LA Rev. Stat. Ann. § 22:669 (1982, 1999)	1999: SB 419	Limited Coverage Severe mental illness: Schizophrenia or schizoaffective disorder, bipolar disorder, pervasive developmental disorder or autism, panic disorder, obsessive-compulsive disorder, major depressive disorder, anorexia/bulimia, Asperger's Disorder, intermittent explosive disorder, posttraumatic stress disorder, Psychosis NOS (not otherwise specified) when diagnosed in a child under seventeen years of age, Rett's Disorder, Tourette's Disorder. Full Coverage Optional coverage for mental disorders other than severe mental illnesses.	Mandate (SMI) Minimum benefits: 45 IP days and 52 OP visits. Mandated Offering (other mental disorders). Benefits shall be payable under the same circumstances and conditions as benefits are paid for all other diagnoses, illnesses, or accidents.	Group, HMO, state employees	n/a
	LA Rev. Stat. Ann. §22:215.5 (1982)		Alcoholism and drug abuse	Mandated Offering Benefits not specified	Group	n/a
Maine	ME Rev. Stat. Tit. 24- §2325A (1996, 2003)	2003: HB 973	Limited Coverage Mental illness: Psychotic disorders, including schizophrenia; dissociative disorders; mood disorders; anxiety disorders; personality disorders; paraphilias; attention deficit and disruptive behavior disorders; pervasive developmental disorders; tic disorders; eating disorders, including bulimia and anorexia; and substance abuse-related disorders. Does not include V Codes.	Mandate Terms and conditions no less extensive than the benefits provided for medical treatment for physical illnesses. There may not be separate maximums, deductibles, coinsurance amounts, out-of-pocket limits, or office visit limits. Co-payments must be actuarially equivalent to any coinsurance requirements or, if there are no coinsurance requirements, may not be greater than any co-payment or coinsurance required under the policy or contract for a benefit or coverage for a physical illness	Group	Businesses with 20 or fewer employees
	ME Rev. Stat. Tit. 24- §2325A (5-D) (1996)		Limited Coverage Schizophrenia; bipolar disorder; pervasive developmental disorder, or autism; paranoia; panic disorder; obsessive-compulsive disorder; or major depressive disorder.	Mandated Offering Benefits must be under terms and conditions that are no less extensive than the benefits provided for medical treatment for physical illnesses. Policies may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.	Group and individual	n/a
Maryland	MD Ins. Code Ann. §15-802 (1993, 2005)	1993: HB 1359	Coverage Defined by Plan Mental illness, emotional disorder, drug abuse disorder, or alcohol abuse disorder	Mandate Must provide benefits under the same terms and conditions that apply to physical illness. At a minimum: IP benefits must be the same; at least 60 days of partial hospitalization; OP benefits cannot be less than 80% for visits 1-5, 65% for visits 6-30, and 50% for visits over 30.	Group, individual, and HMO	n/a
	MD Ins. Code Ann. §15-840		Medically necessary residential crisis services	Residential crisis services as alternative to IP	Group, individual, HMO, and nonprofit health service plans	n/a
Massachusetts	MA Gen Laws Ch. 32A:22 (1993, 2000) for State Employees MA Gen Laws Ch. 175:47B (1996, 2000)	2000: SB 2036	Broad Coverage Biologically-based mental disorders: schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, panic disorder, delirium and dementia, affective disorders, and any biologically-based mental disorders appearing in the DSM that are scientifically recognized and approved by the commissioner of the department of mental health in consultation with the commissioner of the division of insurance. Parity for alcohol and chemical dependency only when treated in conjunction with a mental disorder Limited Coverage Diagnosis and treatment of rape-related mental or emotional disorders to victims of a rape or victims of an assault with intent to commit rape whenever the costs of such diagnosis and treatment exceed the maximum compensation awarded to such victims. Broad Coverage Coverage for children and adolescents under the age of 19 for the diagnosis and treatment of non-biologically-based mental, behavioral or emotional disorders, which substantially interfere with or substantially limit the functioning and social interactions of such a child or adolescent. Broad Coverage Coverage for other mental disorders not listed above but described in the DSM	Mandate Benefits must be provided on a non-discriminatory basis: annual or lifetime dollar or unit of service limitation must be equal to limitations on the coverage of physical conditions Mandate, see above Mandate, see above Mandate Medically necessary benefits: minimum of 60 inpatient days and 24 outpatient visits	State employees; Group, individual, and HMO	n/a
Michigan	MI Compiled Laws §500.3501 (1956, 2000)	2000: SB 1209	Coverage Defined by Plan Mental health and substance abuse	Mandate Charges, terms, and conditions for the services required to be provided shall not be less favorable than the maximum prescribed for any other comparable service. Outpatient mental health only, minimum of 20 visits per year. Substance abuse: a minimum of $2,968.00 in services for intermediate and outpatient care for substance abuse per individual per year (minimum adjusted annually).	HMO: group and individual contracts	Cost increase of 3% or more
Minnesota	MN Stat. §62Q.47 (1995)	1995: SB 845	Coverage Defined by Plan Mental health and chemical dependency	Mandated if Offered Cost-sharing and service limitations for IP and OP services must not place greater financial burden or be more restrictive than other medical services. Mandate (HMOs) MN Rules §4685.0700	Group, individual, and HMO	n/a
	MN Stat. §62A.152 (mental health) MN Stat. §62A.149 (substance abuse)		Mental health and chemical dependency	Mandated if Offered (mental health) Any plan that has an inpatient benefit MUST also have an outpatient benefit with limits the same as other services and co-pays limited to 20% for first 10 hours/year and 25% for any additional treatment.  Prior authorization is also permitted beyond the first 10 hours of treatment Full Parity (substance abuse) Payment of benefits for the treatment of alcoholism, chemical dependency or drug addiction to any Minnesota resident entitled to coverage thereunder on the same basis as coverage for other benefits. At a minimum, 20% of total patient days and no less than 28 days for IP; 130 hours/year OP	Group, (MH); Group and individual (SA)	n/a
Mississippi	MS Code Ann. §83-9-37 to 41 (1975, 2001)		Full Coverage Clinically significant mental illness: any psychiatric disease identified in the current edition of the ICD or the DSM	Mandate Minimum of 30 IP days, 60 days for partial hospitalization, and 52 OP days. The rate of payment for IP services and partial hospitalization shall be the same as provided for any other condition. The rate of payment for OP visits shall be a minimum of 50% of covered expenses which may be limited to a maximum payment of $50.00 per visit.	Group and individual	Cost increase of 1% or more
Missouri	MO Rev. Stat. Title XXIV §376.811 (1997, 2004)	2004: HB 855	Full Coverage Recognized mental illness: those conditions classified as "mental disorders" in the DSM, not including mental retardation. Includes substance abuse.	Mandated Offering Outpatient, residential and inpatient treatment. Coverage and benefits shall be subject to the same coinsurance, co-payment and deductible factors as apply to regular office visits under coverages and benefits for physical illness	Group, individual, and HMO	n/a
	MO Rev. Stat. Title XXIV §§376.825-376.840 (1997, 1999, 2004) Expires January 1, 2011	1999: HB 191 2004: HB 855	Limited Coverage Mental illness: schizophrenic disorders and paranoid states; major depression, bipolar disorder, and other affective psychoses; obsessive compulsive disorder, post-traumatic stress disorder and other major anxiety disorders; early childhood psychoses and other disorders first diagnosed in childhood or adolescence; alcohol and drug abuse; anorexia nervosa, bulimia and other severe eating disorders; and senile organic psychotic conditions	Mandated if Offered Coverage shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to evaluation and treatment for mental illness than for access to evaluation and treatment for physical conditions. Deductibles, co-payment or coinsurance amounts for access to evaluation and treatment for mental illness shall not be unreasonable in relation to the cost of services provided. Substance abuse: minimum 30 days IP, 20 visits OP	Group and individual	Cost increase that results in a 2% increase in premium costs to the policyholder
Montana	MT Code Ann. §33-22-706 (2000)	1999: SB 219	Limited Coverage Severe mental illness: schizophrenia, schizoaffective disorder, bipolar disorder, major depression, panic disorder, obsessive-compulsive disorder and autism.	Mandate Coverage that is no less favorable than that level provided for other physical illness generally. Benefits include but are not limited to: IP services, OP services, rehabilitative services, and medication.	Group, individual, and HMO	n/a
	MT code Ann. §33-22-701 to 705 (1997, 2001)		Broad Coverage Mental illness: a clinically significant behavioral or psychological syndrome or pattern that occurs in a person and that is associated with: present distress or a painful symptom; a disability or impairment in one or more areas of functioning; or a significantly increased risk of suffering death, pain, disability, or an important loss of freedom. Mental illness must be considered as a manifestation of a behavioral, psychological, or biological dysfunction in a person. Mental illness does not include: a developmental disorder; a speech disorder; a psychoactive substance use disorder; an eating disorder, except for bulimia and anorexia nervosa; an impulse control disorder, except for intermittent explosive disorder and trichotillomania.	Mandate Benefits consisting of durational limits, dollar limits, deductibles, and coinsurance factors that are not less favorable than for physical illness generally. Exceptions: 21 days maximum for IP; $6,000/year until a lifetime maximum of $12,000 is met, then coverage reduced to $2,000/year	Group	n/a
Nebraska	NE Rev. Stat. §§44-791 to 795 (1999, 2002)	1999: L 355	Broad Coverage Serious mental illness: any mental health condition that current medical science affirms is caused by a biological disorder of the brain and that substantially limits the life activities of the person with the serious mental illness. Includes, but is not limited to: schizophrenia, schizoaffective disorder, delusional disorder, bipolar affective disorder, major depression, and obsessive-compulsive disorder.	Mandated if Offered Plans shall not establish any rate, term, or condition that places a greater financial burden on an insured for access to treatment for a serious mental illness than for access to treatment for a physical health condition. (Rate, term, or condition means lifetime limits, annual payment limits, and inpatient or outpatient service limits. Rate, term, or condition does not include any deductibles, co-payments, or coinsurance).	Group and HMO	Businesses with 15 or fewer employees
Nevada	NV Rev Stat. (1999) §§ 689A.0455 (Individual) 689B.0359 (Group) 695B.1938 (Nonprofit corps.) 695C.1738 (HMO)	1999: SB 557	Limited Coverage Severe mental illness: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, and obsessive-compulsive disorder.	Mandate Minimum 40 IP days and 40 OP visits, excluding visits for medication management. Deductibles and co-payments must not be greater than 150% of out-of-pocket expenses for medical and surgical benefits.
New Hampshire	NH Stat. §415:18-a (Group and individual) (1993, 2002) §420-B:8-b (HMO)		Broad Coverage Mental illness and emotional disorders: mental disorders, as defined in the most recent edition of DSM, excluding those disorders designated by a "V Code'' and those disorders designated as criteria sets and axes provided for further study in the DSM. Statute includes coverage of substance abuse.	Mandate Coverage for: the treatment of mental illnesses which are subject to improvement through short-term therapy, and diagnosis and evaluation of all other mental illnesses. Policies must cover substance abuse up to a specified limit, and must include IP and OP. Non-major medical plans covering hospital expenses: benefits must be at least as favorable as benefits for other illnesses. Non-major medical plans covering medical expenses: the ratio of benefits to fees for mental illness must be substantially the same as the ratio of benefits to fees for other illnesses. Major medical plans: subject to deductibles and coinsurance at least as favorable as benefits for any other illness. Benefits payable for expenses incurred in any consecutive 12-month period may be limited to an amount not less than $3,000 per covered individual, and to a lifetime maximum of not less than $10,000 per covered individual.	Group, individual and HMO	n/a
	NH Stat. §471:E-1 (1994, 2002)	1994: SB 767 2002: HB 672	Limited Coverage Biologically-based mental illnesses: schizophrenia and other psychotic disorders, schizoaffective disorder, major depressive disorder, bipolar disorder, anorexia nervosa and bulimia nervosa, obsessive-compulsive disorder, panic disorder, pervasive developmental disorder or autism, and chronic post-traumatic stress disorder.	Mandate Benefits begin after above benefits have been exhausted. Benefits for treatment and diagnosis of certain biologically-based mental illnesses under the same terms and conditions and which are no less extensive than coverage provided for any other type of health care for physical illness	Group	n/a
New Jersey	NJ Stat. §17:48-6v (1999) NJ Stat. §17B:26-2.1s	1999: SB 86	Broad Coverage Biologically-based mental illness: a mental or nervous condition that is caused by a biological disorder of the brain and results in a clinically significant or psychological syndrome or pattern that substantially limits the functioning of the person with the illness, including but not limited to, schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, panic disorder and pervasive developmental disorder or autism	Mandate Coverage under the same terms and conditions as provided for any other sickness under the contract (co-payments, deductibles, and benefit limits must be equal to those for medical/surgical benefits).	Group and individual	n/a
New Mexico	NM Stat. Ann. §59A-23E-18 (2000)	2000: HB 452	Limited Coverage Mental health benefits as described in the group health plan, or group health insurance offered in connection with the plan. Does not include substance abuse, chemical dependency or gambling addiction.	Mandate The plan shall not impose treatment limitations or financial requirements on the provision of mental health benefits if identical limitations or requirements are not imposed on coverage of benefits for other conditions	Group	Businesses with 2-49 employees with a cost increase of more than 1.5% may: pay the increase, negotiate cost-sharing, negotiate a reduction in coverage, or remove the coverage completely if the cost increase was due solely to MH benefits. Over 50 employees: same conditions as above if a cost increase of more than 2.5%
New York	NY §3221 & §4303 (1998, 2006)	2006: A 2912	Coverage Defined by Plan Mental, nervous, or emotional disorders or ailments Limited Coverage Biologically based mental illness: schizophrenia/psychotic disorders, major depression, bipolar disorder, delusional disorders, panic disorder, obsessive compulsive disorder, bulimia, and anorexia. Children with SED: attention deficit disorders, disruptive behavior disorders, or pervasive developmental disorders where there are one or more of the following: serious suicidal symptoms, significant psychotic symptoms, behavior caused by emotional disturbances that placed the child at risk of personal injury, property damage or removal from the household.	Mandate Mental health treatment: 30 IP days and 20 OP days. Deductibles and coinsurance must be consistent with those imposed on other benefits. Biologically based and SED: Coverage shall be provided under the terms and conditions otherwise applicable under the policy, including network limitations or variations, exclusions, co-pays, coinsurance, or deductibles. Out-of-network benefits and cost sharing may be different than in-network benefits and cost sharing.	Group and HMO	Businesses with 50 or fewer employees: exempt from covering biologically based mental illness and SED in children, but may opt to provide coverage. These groups are also subsidized by the state for mental health treatment.
North Carolina	NC Gen. Stat. §135-40.7B (1991, 1997)	1991: HB 279 1997: HB 435	Broad Coverage Mental illness and chemical dependency. "Mental illness" means: (i) when applied to an adult, an illness which so lessens the capacity of the individual to use self‑control, judgment, and discretion in the conduct of his affairs and social relations as to make it necessary or advisable for him to be under treatment, care, supervision, guidance, or control; and (ii) when applied to a minor, a mental condition, other than mental retardation alone, that so impairs the youth's capacity to exercise age adequate self‑control or judgment in the conduct of his activities and social relationships so that he is in need of treatment. The term "chemical dependency" means the pathological use or abuse of alcohol or other drugs in a manner or to a degree that produces an impairment in personal, social or occupational functioning and which may, but need not, include a pattern of tolerance and withdrawal.	Mandate Benefits shall be subject to the same deductibles, durational limits, and coinsurance factors as are benefits for physical illness generally. Use of out-of-network providers: 20% coinsurance. Precertification required beyond 26 OP visits.	State employees only	n/a
North Dakota	ND Cent. Code §26.1-36-09 (p.15) §26.1-36-08 (substance abuse, p. 13) (1995, 2003)	2003: SB 2210 (substance abuse)	Coverage Defined by Plan Mental disorders and substance abuse	Mandate Minimum: 45 IP days, 120 days of partial hospitalization, 120 days of residential treatment, 30 OP hours. Regarding partial hospitalization and residential treatment: charges must be reasonably similar to the charges for care provided by hospitals Regarding OP treatment: no deductible or co-payment for the first 5 hours, no co-payment greater than 20% for the remaining hours. Out-of-network: co-pays may be greater than 20% after the first 5 visits.	Group and HMO	Businesses with 50 of fewer employees may have basic health insurance coverage that does not include substance abuse
Ohio	OH Rev. Code §§ 3923.28 3923.281 3923.282 3923.30 (1985,2006) See SB 116 (2006) (Online statutes not up-to-date)	2006: SB 116	Coverage Defined by Plan Mental or emotional disorders Limited Coverage Biologically based mental illness: schizophrenia, schizoaffective disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive-compulsive disorder, and panic disorder	Mandated if Offered OP services equal to at least $550/year. Subject to reasonable deductibles and coinsurance Mandate (biologically based) Coverage under the same terms and conditions as, and shall provide benefits no less extensive than, those provided under the policy of sickness and accident insurance for the treatment and diagnosis of all other physical diseases and disorders	Group	Regarding biologically-based mental illness: Incurred claims for biologically based mental illness caused a 1% or more increase in the cost for claims and administrative expenses, and that increase could justifiably cause a 1% or more increase in premiums
Oklahoma	OK Stat. Title 36 §§6060.10 6060.11 6060.12 (1999)	1999: SB 2	Limited Coverage Severe mental illness: schizophrenia, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, and schizoaffective disorder.	Mandate Benefits shall be equal to benefits for treatment of and shall be subject to the same preauthorization and utilization review mechanisms and other terms and conditions as all other physical diseases and disorders (Including medication, IP, OP, co-pays, coinsurance and deductibles)	Group	Businesses with 50 or fewer employees, or 2% increase in base premium costs
Oregon	OR Rev. Stat. §743.556 (2000, 2005)	2005: SB 1 2005: SB 913	Coverage Defined by Plan Mental or nervous conditions and chemical dependency, including alcoholism	Mandate Benefits must be at the same level as, and subject to limitations no more restrictive than, those imposed on coverage or reimbursement of expenses arising from treatment for other medical conditions. Deductibles and coinsurance for treatment in health care facilities or residential programs or facilities may not be greater than those for expenses of hospitalization in the treatment of other medical conditions. Deductibles and coinsurance for outpatient treatment may not be greater than for expenses of outpatient treatment of other medical conditions.	Group and HMO	n/a
Pennsylvania	Act No. 150 §634 (HB 366) (1998)	1998: HB 366	Limited Coverage Serious mental illness: schizophrenia, bipolar disorder, obsessive-compulsive disorder, major depressive disorder, panic disorder, anorexia nervosa, bulimia nervosa, schizoaffective disorder and delusional disorder.	Mandate 30 IP days, 60 OP days Annual lifetime and dollar limits must be equal to those for other illnesses. Cost-sharing arrangements must not prohibit access to care	Group and HMO	Businesses with 50 or fewer employees
Rhode Island	RI Gen. Laws §§27-38-2 (1-5) (1995, 2002)	2001: HB 5478 2001: SB 832	Broad Coverage Mental illnesses: any mental disorder and substance abuse disorder that is listed in the most recent revised publication or the most updated volume of either the DSM or the International Classification of Disease Manual and that substantially limits the life activities of the person with the illness; provided, that tobacco and caffeine are excluded from the definition of "substance" for the purposes of this chapter. "Mental illness" shall not include: mental retardation, learning disorders, motor skills disorders, communication disorders, and mental disorders classified as "V" codes.	Mandate Coverage must be under the same terms and conditions as that coverage is provided for other illnesses and diseases. Insurance coverage offered pursuant to this statute must include the same durational limits, amount limits, deductibles, and co-insurance factors for mental illness as for other illnesses and diseases.	Group, individual, and HMO	n/a
South Carolina	SC Code §38-71-737 (1994)		Full Coverage Psychiatric conditions: those mental and nervous conditions, drug and substance addiction or abuse, alcoholism, or other conditions that are defined, described, or classified as psychiatric disorders or conditions in the most current publication of DSM.	Mandated Offering Benefits and out-of-pocket payments may be different Minimum coverage of $2,000 per year and $10,000 lifetime.	Group	n/a
	§38-71-290 (2005)	2005: SB 49	Limited Coverage Mental health conditions: bipolar disorder, major depressive disorder, obsessive compulsive disorder, paranoid and other psychotic disorder, schizoaffective disorder, schizophrenia, anxiety disorder, post-traumatic stress disorder, and depression in childhood and adolescence	Mandate A plan may not establish a rate, term, or condition that places a greater financial burden on an insured for access to treatment for a mental health condition than for access to treatment for a physical health condition. Any deductible or out-of-pocket limits required under a health insurance plan must be comprehensive for coverage of both mental health and physical health conditions. However, the section does not require a health insurance plan to provide rates, terms, or conditions for access to treatment for mental illness that are identical to rates, terms, or conditions for access to treatment for a physical condition.	Group, individual, and HMO	n/a
	SC Code §1-11-760 (2000) Reenacted by SC Code §1-11-780 (2005) (State Employees Only)	2000: SB 1041	Limited Coverage Mental health conditions: schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, pervasive developmental disorder or autism, panic disorder, obsessive-compulsive disorder, social anxiety disorder, anorexia, bulimia, Asperger's disorder, intermittent explosive disorder, post-traumatic stress disorder, psychosis not otherwise specified when diagnosed in a child under seventeen years of age, Rett's disorder, or Tourette's disorder. Includes substance abuse.	Mandate A plan shall not establish any term or condition that places a greater financial burden on an insured for access to treatment for a mental health condition or alcohol or substance abuse than for access to treatment for a physical health condition. Any deductible or out-of-pocket limits required under the state health insurance plan must be comprehensive for coverage of mental health conditions, alcohol or substance abuse, and physical health conditions	State employees only	Cost increase of 1% at the end of three years, or a 3.39% increase at any time.
South Dakota	SD Codified Laws §58-17-98 (1998)	1998: HB 1262	Limited Coverage Biologically based mental illness: Schizophrenia and other psychotic disorders, bipolar disorder, major depression, and obsessive-compulsive disorder.	Mandate The same dollar limits, deductibles, coinsurance factors, and restrictions as for other covered illnesses.	Group, individual, and HMO	n/a
Tennessee	TN Code §56-7-2360 (1998)	1998: HB 3177	Coverage Defined by Plan Mental illness, substance abuse not included	Mandate Aggregate lifetime and annual limits must be the same as those for medical/surgical. A minimum of 20 IP days and 25 OP visits must be covered. Limits for MH cost-sharing cannot be greater than those for medical/surgical. Coinsurance, co-payments, deductibles, or differentials may be different.	Group	Businesses with 25 or fewer employees, or a cost increase of more than 1%
	§56-7-2601 (1974, 1998)		Coverage Defined by Plan Psychiatric disorders, mental or nervous conditions, alcoholism, drug dependence, or the medical complication of mental illness or mental retardation.	Mandated Offering Aggregate lifetime and annual limits (for mental health benefits, not substance abuse) must be the same as those for medical/surgical	Group and individual	Businesses with 50 or fewer employees or a cost increase of at least 1%
Texas	TX Stat. Title 2 Chapter 1355 (1997, 2003)	1997: HB 1173 2003: SB 541	Limited Coverage Serious mental illness: bipolar disorders, depression in childhood and adolescence, major depressive disorders, obsessive-compulsive disorders, paranoid and other psychotic disorders, pervasive developmental disorders, schizo-affective disorders, and schizophrenia.	Mandate 45 IP days, 60 OP visits. May not include a lifetime limit and must include the same amount limitations, deductibles, co-payments, and coinsurance factors for serious mental illness as the plan includes for physical illness. (Mandated Offering to small employers)	Group and HMO	Businesses with 50 or fewer employees
Utah	UT Code Ann. 31A-22-625 (2000)	2000: HB 35	Broad Coverage Mental health condition: any condition or disorder involving mental illness that falls under any of the diagnostic categories listed in the DSM. Does not include the following when diagnosed as the primary or substantial reason or need for treatment: marital or family problem; social, occupational, religious, or other social maladjustment; conduct disorder; chronic adjustment disorder; psychosexual disorder; chronic organic brain syndrome; personality disorder; specific developmental disorder or learning disability; or mental retardation.	Mandated Offering Insurers must offer a choice between catastrophic mental health coverage and 50/50 mental health coverage. A “catastrophic” policy does not impose any lifetime limit, annual payment limit, episodic limit, inpatient or outpatient service limit, or maximum out-of-pocket limit that places a greater financial burden on an insured for the evaluation and treatment of a mental health condition than for the evaluation and treatment of a physical health condition. However it may include a restriction on cost sharing factors, such as deductibles, co-payments, or coinsurance, prior to reaching any maximum out-of-pocket limit. A “50/50” policy pays for at least 50% of covered services for the diagnosis and treatment of mental health conditions and may include a restriction on episodic limits, inpatient or outpatient service limits, or maximum out-of-pocket limits.	Group and HMO	n/a
Vermont	VT Stat. Ann. Tit. 8 §4089b (1997)	1997: HB 57	Full Coverage Mental health condition: any condition or disorder involving mental illness or alcohol or substance abuse that falls under any of the diagnostic categories listed in the mental disorders section of the ICD, as periodically revised. Includes substance abuse.	Mandate Plans must not establish any rate, term, or condition that places a greater financial burden on an insured for access to treatment for a mental health condition than for access to treatment for a physical health condition. Plans must make deductible or out-of-pocket limits required under a health insurance plan comprehensive for coverage of both mental health and physical health conditions.	Group and individual	n/a
Virginia	VA Code §38.2-3412.1:01 (1999)	1999: SB 430	Limited Coverage Biologically based mental illness: schizophrenia, schizoaffective disorder, bipolar disorder, major depressive disorder, panic disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, autism, and drug and alcoholism addiction.	Mandate Coverage shall neither be different nor separate from coverage for any other illness, condition or disorder for purposes of determining deductibles, benefit year or lifetime durational limits, benefit year or lifetime dollar limits, lifetime episodes or treatment limits, co-payment and coinsurance factors, and benefit year maximum for deductibles and co-payment and coinsurance factors.	Group, individual, and HMO	Businesses with 25 or fewer employees
	§38.2-3412.1 (2004)		Coverage Defined by Plan Mental, emotional, or nervous disorders. Substance abuse included	Mandate Minimum 20 IP days for adults and 25 IP days for children, and 20 OP visits for adults and children. Coverage shall be no more restrictive than the limits of benefits applicable to physical illness; however, the coinsurance factor applicable to any outpatient visit beyond the first five of such visits covered in any policy or contract year shall be at least fifty percent.	Group and individual	n/a
Washington	WA Rev. Code §48.21.241 (G/HMO) §48.44.341 (Individual) (See HB 1460, online statutes not yet updated) (2005, 2007)	2005: HB 1154 2007: HB 1460	Broad Coverage Mental health services: mental disorders covered by the DSM. Excludes: substance abuse; V Codes and diagnostic codes 302-302.9 in DSM-IV; skilled nursing facility services, home health care, residential treatment, and custodial care; and court ordered treatment unless medically necessary.	Mandate Parity phased in (compared to coverage for medical/surgical): coinsurance and co-payments in 2006, maximum out-of-pocket in 2008, and deductibles in 2010.	Group, individual, and HMO	n/a
	§48.21.240 (1987, 2005)		Coverage Defined by Plan Mental health treatment	Mandated Offering Applies to groups not covered by above	Group	n/a
West Virginia	WV Code §33-16-3a (1998, 2002)	2002: HB 4039	Limited Coverage Serious mental illness: schizophrenia and other psychotic disorders, bipolar disorders, depressive disorders, substance-related disorders with the exception of caffeine-related disorders and nicotine-related disorders, anxiety disorders, anorexia and bulimia.	Mandate The insurer shall not discriminate between medical-surgical benefits and mental health benefits in the administration of its plan. Aggregate lifetime and annual limits must be equal.	Group and individual	Projected cost increase of more than 2%, for groups with 25 or fewer members: a projected cost increase of more than 1%
Wisconsin	WI Stat. §632.89 (1998)		Coverage Defined by Plan Nervous and mental disorders. Substance abuse included.	Mandate The lesser of 30 IP days or $7,000 ($6,300 if no cost sharing); $2,000 in OP services ($1,800 if no cost sharing); and $3,000 in transitional treatment arrangements ($2,700 if no cost sharing).	Group	n/a
Wyoming	No Parity Law

* Full Coverage: All diagnoses in the DSM and/or ICD are covered

Broad Coverage: All diagnoses in the DSM and/or ICD are covered, but with significant exceptions; or the state’s language is broadly worded and does not restrict coverage to certain groups

Limited Coverage: Coverage is restricted to certain groups specified in the state’s language

Coverage Defined by Plan: The populations to be covered are not specified in the state statute

^† ICD: The International Classification of Diseases, published by the World Health Organization, currently in its 10^th edition.

^†† DSM: The Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association, currently in its fourth edition (DSM-IV-TR)