§ 27-38.2-2 - Definitions. - Rhode Island Statutes

SECTION 27-38.2-2

   § 27-38.2-2  Definitions. – For the purposes of this chapter, the following words and terms have thefollowing meanings:

   (1) "Health insurers" means all persons, firms, corporations,or other organizations offering and assuring health services on a prepaid orprimarily expense-incurred basis, including but not limited to policies ofaccident or sickness insurance, as defined by chapter 18 of this title,nonprofit hospital or medical service plans, whether organized under chapter 19or 20 of this title or under any public law or by special act of the generalassembly, health maintenance organizations, or any other entity which insuresor reimburses for diagnostic, therapeutic, or preventive services to adetermined population on the basis of a periodic premium. Provided, thischapter does not apply to insurance coverage providing benefits for:

   (i) Hospital confinement indemnity;

   (ii) Disability income;

   (iii) Accident only;

   (iv) Long-term care;

   (v) Medicare supplement;

   (vi) Limited benefit health;

   (vii) Specific disease indemnity;

   (viii) Sickness or bodily injury or death by accident orboth; and

   (ix) Other limited benefit policies.

   (2) "Mental illness" means any mental disorder and substanceabuse disorder that is listed in the most recent revised publication or themost updated volume of either the Diagnostic and Statistical Manual of MentalDisorders (DSM) published by the American Psychiatric Association or theInternational Classification of Disease Manual (ICO) published by the WorldHealth Organization and that substantially limits the life activities of theperson with the illness; provided, that tobacco and caffeine are excluded fromthe definition of "substance" for the purposes of this chapter. "Mentalillness" shall not include: (i) mental retardation, (ii) learning disorders,(iii) motor skills disorders, (iv) communication disorders, and (v) mentaldisorders classified as "V" codes. Nothing shall preclude persons with theseconditions from receiving benefits provided under this chapter for any otherdiagnoses covered by this chapter.

   (3) "Mental illness coverage" means inpatienthospitalization, partial hospitalization provided in a hospital or any otherlicensed facility, intensive out patient services, outpatient services andcommunity residential care services for substance abuse treatment. It shall notinclude methadone maintenance services or community residential care servicesfor mental illnesses other than substance abuse disorders.

   (4) "Outpatient services" means office visits that providefor the treatment of mental illness and substance abuse.

   (5) "Community residential care services" mean thosefacilities as defined and licensed in accordance with chapter 24 of title 40.1.