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Description
House Insurance Committee- January 25, 2022- House Hearing Room 1
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C
Thank
you,
madam
chair
lady.
I
just
like
to
introduce
my
intern
she's
shadowing
me
today,
I'm
very
proud
to
have
an
intern
this
year,
she's
been
very
helpful
so
far,
and
in
the
back
I
have
miss
sherry,
sampson
sheriff
you'll
stand
up
right
to
him
right
there.
Let's
everyone
give
her
a
good
round
of
applause.
Welcome.
D
Thank
you
for
making
time
this
morning
to
hear
about
mental
health,
parity
and
letting
us
present
this
report,
or
this
presentation
report
was
submitted
yesterday.
This
issue,
I
know,
is
something:
that's
touched.
Probably
everybody
in
this
room
at
some
point,
especially
over
the
past
year
and
a
half
or
two
has
been
exacerbated
by
different
things,
with
covid.
D
I
I
would
like
to
say
my
intent
was
to
have:
I
have
an
outreach
specialist
who
actually
goes
out
and
does
presentations
on
mental
health
parity.
She
was
going
to
be
with
me
today.
She
presents
to
the
consumer,
and
so
we
were
going
to
be
able
to
see
from
that
standpoint
an
educational
piece,
unfortunately
she's
ill,
so
going
to
just
be
me
today
talking
about
some
highlights
from
the
report
that
we
submitted
and
how
we
regulate
for
mental
health
parity
at
the
department.
D
D
D
We
regulate
fully
insured
plans
in
small
group
and
large
group,
so
the
rest
of
that
falls
under
some
federal
oversight
preempted
by
erisa,
but
we
have
that
authority
over
about
30
percent
of
the
market.
So
with
that
being
said,
I'd
like
to
kind
of
go
into
the
ways
we
regulate
and
I've
got
a
slide
deck
here.
D
D
They
have
to
be
approved
by
our
department
and
all
forms
rates
come
through
us.
We
review
for
multiple
things
specifically
on
mental
health
parity.
We
look
at
quantitative
treatment
limitations
and
non-quantitative
treatment
limitations,
so
examples
would
be,
for
instance,
on
the
quantitative
side.
We
want
to
make
sure
that
cost
sharing
for
mental
health
services
is
at
parity
with
non-mental
health
services
and
visit
limitations
would
be
another
one.
We
also
review
non-quantitative
treatment
limitations
and
those
type
of
an
example
of
that
would
be
step
therapy
or
prior
authorization
credentialing.
D
Those
type
of
things
are
what
we
look
at
there.
So
when
we
look
for
those
things,
if
we
find,
if
we,
if
we
find
mistakes
within
the
policy,
we
send
it
back
to
the
carrier.
The
carrier
corrects
that
and
if
it's
suitable,
then
we
approve
those
are
all
submitted
through
a
system
called
surf,
it's
an
elect,
it's
it's
electronic
rate
form
and
filing
system,
and
that
is
all
public
information.
D
So
it's
out
there
as
soon
as
it's
filed,
you
can
see
the
communication
and
the
forms,
and
you
can
get
to
that
through
our
website,
so
that's
easily
accessible
to
anybody
that
wants
to
see
that
last
year
we
found,
I
think,
a
dozen
corrections
and
the
specifically
for
mental
health
parity.
There
were
some
that
had
to
do
with
age
discrimination
on
a
they
had
applied
but
applied
behavior
analysis.
D
One
carrier
had
it
for
12
years
old
and
under,
and
we
sent
it
back
because
to
be
a
parody
with
the
other
coverages
they
had
to
be
at
19
years
old.
So
we
we
sent
that
back.
They
corrected
it
and
it
got
approved.
That's
kind
of
the
before
before
it
ever
goes
to
market.
That's
what
we're
looking
at
so
from
there
we
regulate.
The
deering
part
is
our
consumer
information,
consumer
insurance
services
and
they
they
she.
D
D
D
D
D
All
of
these
complaints
are
kept.
We
keep
records
of
those
we
code
it
and
keep
those
records
retained
in
uniformity,
with
some
naic
or
national
association
of
insurance,
commissioner
standards,
so
that
that's
that's
all
there
that
a
lot
of
that
information
is
confidential,
though,
because
of
the
sensitive
nature
that
it
with
the
consumer.
So
the
I'm
gonna
kind
of
move
on
to
that.
The
next
piece
is
the
after
part.
Now
the.
D
We
do
examinations
statutorily
required
and
those
are
every
five
years
we
have
to
do
those
for
accreditation
so
that
our
insurance
companies
that
are
domestics
here
can
be
accepted
in
other
states
and
out
of
our
domestics.
We
have
68
domestic
insurance
companies
in
tennessee
that
were
responsible
for
performing
those
examinations.
D
D
None
of
those
out
of
the
68
were
for
that
were
required
to
have
mental
health
parity.
They
were
not
health
companies
right
now,
we
are
in
the
process
of
examinations,
and
we
have
14
that
are
going
right
now
that
are
in
process
two
of
those
are
about
or
on
companies
that
have
those
mental
health
requirements.
D
We've
added
to
the
market
conduct
reviews
that
are
already
in
that
were
already
in
the
examination
process.
We've
added
some
analysis
for
mental
health
parity
and
the
specifically
to
look
at
at
mental
health
parity,
and
we
will
have
those
reports
they
should
be
adopted
by
june
and
posted
to
the
website.
D
D
If
there
another
important
thing
about
that
is
when
we
will
review
what
the
work
that's
done
on
that
market
conduct
exam
and
if
there
is,
you
know
a
financial
penalty
on
that
company.
When
all
is
said
and
done,
we
will
receive
a
share
of
that
money,
those
funds
and
it's
based
on
policies
written
in
the
state.
D
We've
done
some
things
based
on
those
suggestions.
We've
worked
on
our
website.
We've
made
it
more
friendly,
more
readable,
we've
actually
created
a
paid
a
page
on
the
website,
specifically
for
mental
health.
Parity
we've
also
done
some
op-eds.
We've
really
done
press
releases
with
other
agencies
and
some
social
media
information,
so
we've
been
involved
in
a,
I
think,
a
couple
of
one
or
two
town
halls.
D
View
of
what
we've
done
with
outreach,
but
that's
kind
of
what
I
have
today,
I'm
glad
to
answer
any
questions.
I
know
we
just
submitted
that
report
yesterday,
but
if
you
know
you
have
questions
a
week
or
two
from
now
after
reviewing
that,
I'm
always
available
always
glad
to
help.
However,
I
can
so
thanks.
E
Thank
you,
madam
chair
director.
Nelson.
Thank
you
very
much
for
being
here.
I
appreciate
it.
You
may
have
stated
this
before
and
I
want
to
state
it
how
critically
important
it
is
that
we
ensure
tennesseans,
have
the
availability
of
these
mental
health,
behavior
health
services
and
insurance
is
a
big
part
of
that.
You
may
have
said
this
before,
but
but
fill
in
the
blank.
For
me
all
the
health
insurance
entities
that
we
regulated
tennessee
do
they
all
provide
a
mental
health,
behavior
health
component
to
their
service.
D
So
not
all
of
them
do
or
not
all
of
them
are
required
to
the
most
of
what
we
regulate
at
the
department
does
have
to
does
require
that
those
coverages
there
are
certain
entities
at
the
department
that
we
have
jurisdiction
over.
That
aren't
part
of
that.
Eight
that
are
listed
in
the
report,
such
as
association
health
plans,
miwas,
don't
have
to
offer
it,
but
then
there's
also
the
piece
that
is
outside
of
our
jurisdiction
that
is
sold
here.
D
E
D
E
And
just
just
to
finish
up
the
thought
and
thank
you
again
chair,
ladies,
it's
critically
important
to
to
all
of
our
constituents
and
becomes
more
and
more
as
you
open.
Your
comments
becomes
becoming
more
and
more
important,
all
the
time.
As
we
see
young
school
children,
my
younger
daughter's
elementary
school,
there
was
a.
There
was
a
second
grader
who
had
to
be
institutionalized
for
a
brief
time
because
of
a
episode
that
they
were
having
at
school
and
it's
becoming
more
and
more
and
more
important.
E
All
the
time
and
the
fact
that
we're
recognizing
that
as
a
state
saying
that
we're
here
to
do
something
about
that
and
want
to,
you
know,
want
to
make
our
state
as
good
as
it
possibly
can.
Providing
these
particular
opportunities
for
our
citizens
to
seek
care
is
critically
important.
So
thank
you
for
the
work
that
the
department
does.
Thank
you,
madam
chair,
for
allowing
me
to
say
a
word.
F
F
D
Yes,
thank
you
representative,
it's
so
it's
and
it
is
kind
of
hard
to
to
clarify
some
of
it
because
of
those
lines
between
different
types
of
plans
and
and
and
what
might
be
non-orissa
or
erisa.
But
I
think
the
the
what
what
might
what
might
answer
your
question
best
is
if
for
mental
health
parity,
if
the
coverage
is
offered,
it
has
to
be
at
parity
with
those
non-mental
health
services.
D
F
Thank
you.
Let
me
let
me
try
a
scenario
then
I'm
a
small
business
owner
I
employ
my
family
and
a
couple
other
people,
I'm
looking
for
the
best
bargain
basement
rate
health
insurance.
I
can
for
catastrophic
coverage
just
to
make
sure
that
we
don't
go
bankrupt
for
a
health
cause
on
a
policy
like
that.
Do
I
have
a
choice
to
say
no,
thank
you.
I
don't
want
to
pay
extra
premium
for
mental
health
coverage,
or
is
that
bundled
together
and
grouped
in
with
all
of
it?
D
Thank
you
sure.
Thank
you
thanks.
So
with
a
self-insured
plan
it
with,
when
you
say
small
business
owner
that
immediately
makes
me
think
you're
paying
for
part
of
it,
so
it's
self-insured
not
fully
insured
and
again
some
of
those
it
depends
on
the
groups.
So
I
think
the
large
group,
if
you
have
a
lar,
if
it's
it's
a
large
insured
group,
that's
not
required
to
be
covered.
G
Chair
lady,
thank
you
for
being
here,
mr
huddleston
and
a
couple
of
questions,
and
if
the
cheerleader
would
indulge
me
on
these
back
to
the
the
idea
of
complaints,
I
understand
that
I've
worked
personally
with
miss
trice,
she's,
fantastic
hope.
She
gets
a
bonus
or
something
because
for
all
the
hard
work
she
does.
But
all
to
be
said
am
I
hearing.
G
But
when
you
are
doing
your
market
review,
are
you
all
looking
more
for
standards
like,
for
instance,
network
adequacy
and
who
defines
that?
Is
it
the?
Is
it
you
as
the
tdci
entity,
or
is
it
the
the
provider
that
defines
network
adequacy
because
so
many
times?
I
hear
that
it's
hard
to
get
in
to
see
anyone,
whether
it's
behavioral
health,
counseling,
psychiatry
whatever,
and
so,
while
that
may
be
a
complaint
it.
You
know
it
really
doesn't
matter.
D
For
the
kind
words
about
about
vicki,
she
does
a
great
job.
So
thank
you
I
so
there
on
that
that
piece
when
it
gets
to
her.
It
is
about
the
complaint
we
do
in
the
examination
piece
and-
and
this
is
not
just
the
state
level
either.
This
also
goes
to
some
of
the
federal
oversight
they
they
look
at.
They
also
look
at
standards,
and
so
when,
and
especially
in
that
non-quantitative
treatment.
D
In
that
piece
of
the
analysis,
there
is
substantive
work
done,
not
just
review
to
say:
hey
did
was
the
analysis
complete,
but
but
is
this
really
living
up
to
what
is
expected
in
operation?
Is
it
operationally
what
it's
supposed
to
be
so
as
far
as
specifically
on
on
network
adequacy
right
now,
we
we
have
to.
We
rely
on
the
definition
that
is
at
the
federal
level.
I
don't
have
a
state
definition
for
it.
I
just
I
don't
have
it.
G
You
know
one
of
the
things
I'm
aware
of
is
in
in
the
space
of
tenncare,
so
many
folks
end
up
being
served
by
tenncare
with
mental
illness
because
they
don't
have
the
capacity
to
work
and
therefore
they
lose
their
their
health
insurance.
So
in
the
space
of
tenncare-
and
I
know
that
your
report-
I
think,
on
one
of
the
last
couple
of
pages
that
you
issued
yesterday-
referenced
that
tdci
has
oversight
with
tenncare
kind
of
walk
me
through
the
process.
Does
do
do
our
mcos
provide
that
coverage
directly?
G
Do
they
contract
that
out
again
back
to
the
network
adequacy?
Who
who
makes
that
determination?
And
how
is
it
that
you
test
that?
Because,
as
I
understand
you
know,
we
made
a
few
little
headlines
last
year
because
of
owing
some
money
back
to
cms
because
of
some
lack
of
benefits
that
were
not
provided
in
that
that
behavioral
health
space.
So
if
you
would
kind
of
speak
to,
how
is
it
that
that
tenncare
patients
receive
behavioral
health,
mental
health
parity?
How
do
you
oversee
that
and
kind
of
give
us
an
update
on
that
oversight?
Issue.
D
Sure
thing
I'll
do
my
best
we
have
I
so
tenncare
is
at
the
department.
It
is
not
under
that's
a
different
piece
from
me,
so
we
have
a
different
assistant,
commissioner,
that
oversees
that
so,
but
I'm
going
to
do
my
best
to
to
to
answer
that
and
if,
if
we
need
more
details,
I'm
I'm
glad
to
get
that
to
you
later.
D
But
I
know
that
some
of
it
is
contracted
out
that
those
there
are
the
federal
requirements
that
they
have
to
meet
and
that
every
year,
as
required
by
statute
report
is
turned,
is
submitted
by
those
mcos
to
to
tenncare
to
to
for
the
reporting
on
those
standards
and
and
to
make
sure
I
I
think
if
I
understood
correctly
last
year,
those
reports
as
they
were
turned
in.
I
don't
think
that
any
issues
were
noted
that
I
was
made
aware
of
that
now
that
again,
I'm
not
in
the
details
on
that.
G
It's
okay,
chairman,
if
you
wouldn't
mind,
following
up
just
with
an
email,
because
I'd
really
like
to
understand
the
process,
because
I
just
know
that
a
larger,
a
growing
portion
of
our
tenncare
population
is
indeed
assigned
with
a
mental
health
diagnosis
and
if
we
don't
have
adequate
providers,
if
we
don't
have
network
adequacy-
and
I
just
want
to
understand
where
we
stand
in.
All
of
that-
that
would
be
very
helpful.
But
thank
you
for
so
much
for
your
responses.