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of Osteopathy or a licensed or registered alcohol and drug | | abuse counselor employed by a certified or licensed substance | | abuse program, including, but not limited to, the patient's | | medical, drug and alcoholism history; record of physical | | examination; diagnosis; assessment of physical capabilities; | | mental capacity; orders for medication, diet and special needs | | for the patient's health or safety and treatment, including | | medical, psychiatric, psychological, social services, | | individual, family and group counseling; and educational, | | support and referral services. |
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| | | 2.__Requirement.__An insurer that issues individual health | | care contracts to residents of this State shall provide benefits | | as required in this section to a person covered under those | | contracts for the treatment of alcoholism and other drug | | dependency pursuant to a treatment plan. |
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| | | 3.__Parity coverage.__An individual contract must provide, at | | a minimum, benefits for the treatment of alcoholism and other | | drug dependency, including benefits for residential treatment and | | outpatient care, under terms and conditions that are no less | | extensive than the benefits provided for medical treatment for | | physical illness. At the request of an insurer, a provider of | | treatment for alcoholism or other drug dependency shall furnish | | data substantiating that the initial or continued treatment is | | medically necessary and appropriate pursuant to a treatment plan. |
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| | | 4.__Limits; coinsurance; deductibles.__A policy or contract | | that provides coverage for the services required by this section | | 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. |
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| | | 5.__Notice.__At the time of delivery or renewal, the | | individual health insurer shall provide written notification to | | all individuals eligible for benefits under individual policies | | or contracts of the alcoholism and drug dependency benefits | | provided under this section. |
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| | | 6.__Confidentiality.__The confidentiality of alcoholism and | | drug treatment patient records must be protected. |
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| | | 7.__Reports to the superintendent.__Beginning with the year | | 2000, an insurer subject to this section shall report its | | experience for each calendar year to the superintendent not later | | than April 30th of the following year.__The report must be in a | | form prescribed by the superintendent and include the amount of | | claims paid in this State for the services required by this | | section and the total amount of claims paid in this State for |
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