ARIZONA HOUSE OF REPRESENTATIVES

Fifty-seventh Legislature

First Regular Session

House: APPROP DPA 18-0-0-0

HB 2332: postpartum depression; treatment; insurers

Sponsor: Representative Willoughby, LD 13

Caucus & COW

Overview

Requires health care insurers and the Arizona Health Care Cost Containment System (AHCCCS) to provide coverage for postpartum depression (PPD) screening and prohibits step therapy protocol from being imposed for drugs approved for the treatment of PPD by the Food and Drug Administration (FDA). Directs the Arizona Department of Health Services (DHS) to develop and distribute resources for maternal mental health conditions.

History

Health care insurers include disability insurers, group disability insurers, blanket disability insurers, health care services organizations, hospital service corporations and medical service corporations (insurers) (A.R.S. § 20-1379). AHCCCS contracts with health professionals to provide medically necessary health and medical services to eligible members, including inpatient and outpatient health services and early and periodic health screening and diagnostic services (A.R.S. § 36-2907). The Department of Insurance and Financial Institutions regulates policies, certificates, evidence of coverage and contracts of insurance (insurance policies) that are issued or delivered by health care insurers.

PPD screening consists of the use of a standard criterion-referenced screening tool for screening of the mother/parent for signs and symptoms of PPD during the one-, two-, four- and six-month well-child visits. Positive screening results require referral to appropriate case managers and services via the respective health plan (AHCCCS).

Provisions

1. Requires an insurance policy, by January 1, 2026, to provide coverage for PPD screening and additional reimbursement costs to adequately compensate a health care professional for the screening. (Sec. 1-5).

2. Requires AHCCCS and its contractors to provide coverage for PPD screening and reimbursement costs to adequately compensate a health care professional for the screening. (Sec. 8)

3. Requires health care insurers and AHCCCS to provide broad access to PPD screening that is consistent with evidence-based guidelines. (Sec. 1-5)

4. Prohibits a health care insurer, health care plan, pharmacy benefit manager, utilization review agent and AHCCCS or its contractors from requiring or imposing a step therapy protocol for an FDA approved drug used to treat PPD. (Sec. 6, 8)

5. Requires DHS to develop written educational materials and information for health care professionals and patients regarding maternal health conditions, including PPD. (Sec. 7)

6. Specifies that the materials must include information on the symptoms and methods of coping with PPD, as well as treatment options and resources. (Sec. 7)

7. Directs DHS to periodically review the materials and information for accuracy. (Sec. 7)

8. Instructs DHS to post the materials on its public website and make physical forms of the materials available or distributable on request. (Sec. 7)

9. Requires health care institutions, as appropriate, to distribute the materials to new parents and family members on discharge. (Sec. 7)

10. Requires any health care institution, primary care physician or practitioner or any health care professional who renders postnatal care or provides pediatric infant care to provide the materials to any woman who presents signs of a maternal mental health disorder. (Sec. 7)

11. Requires any primary care physician or practitioner, or any health care professional who renders postnatal care or provides pediatric infant care to ensure PPD screening is offered to the patient or the birth mother of the infant patient, as applicable. (Sec. 7)

12. Specifies that if there is no objection to the PPD screening, the health care professional must ensure that the patient is appropriately screened for PPD consistent with evidence-based guidelines. (Sec. 7)

13. Requires a health professional that determines through PPD screening that a patient is likely to be suffering from PPD to provide appropriate referrals and discuss the availability of treatments for PPD, including pharmacological treatments. (Sec. 7)

14. Defines health care institution, primary care physician and primary care practitioner. (Sec. 7)

Amendments

Committee on Appropriations

1. Removes provisions that require health care insurers and AHCCCS to provide coverage related to PPD screening.

2. Requires DHS to identify and compile relevant educational materials and information regarding maternal health conditions that have been developed by organizations with expertise in mental health conditions.

3. Directs DHS to periodically review the materials and information to ensure accuracy and reflect the most up-to-date information.

4. Instructs DHS if unable to identify existing materials to take into consideration the following when developing written educational materials:

a) relevant clinical practice guidelines;

b) peer-reviewed studies; and

c) recommendations from expert in maternal mental health care, including:

i. the Centers for Disease Control and Prevention;

ii. professional associations; and

iii. patient advocacy groups.

5. Requires any health care institution, primary care physician or practitioner or any health care professional who renders prenatal care to provide the compiled materials to any woman on learning of a pregnancy or who presents signs of a maternal health disorder at any time during a pregnancy or postpartum period.

6. Makes conforming changes.

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