Mental Health Services Allowed Out-ofNetwork

PURPOSE: This rule sets forth with greater specificity the breadth of options available for the provision of mental health services. This rule is promulgated pursuant to section 376.814, RSMo, and implements section 376.811.4, RSMo. Pursuant to section 376.811.4, RSMo Supp. 2012, an insurance company, health services corporation or health maintenance organization, must offer in all health insurance policies at least two (2) sessions per year for the purpose of diagnosis or assessment of mental health. This offer may not limit the choice of psychiatrist, licensed psychologist, licensed professional counselor or licensed clinical social worker, or, subject to contractual provisions, a licensed marital and family therapist who provides the service. An insured or enrollee may seek these services outside an insurer’s network if he or she is covered by an insurance company, a health services corporation, or a point of service plan provided by a health maintenance organization. AUTHORITY: section 376.811.4, RSMo Supp. 2013, and section 376.814, RSMo 2000.* Original rule filed Nov. 3, 1997, effective June 30, 1998. Amended: Filed Aug. 19, 2013, effective Feb. 28, 2014. *Original authority: 376.811, RSMo 1991, amended 1997, 1999, 2004, 2009 and 376.814, RSMo 1991, amended 1993.