LD 1000
pg. 5
Page 4 of 7 An Act to Provide Insurance Parity for Substance Abuse Treatment Page 6 of 7
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LR 1458
Item 1

 
of this section, all contracts shall be are deemed to be renewed no
later than the next yearly anniversary of the contract date.

 
Sec. 14. 24-A MRSA §4245 is enacted to read:

 
§4245.__Equitable health care for alcoholism and drug dependency

 
treatment

 
1.__Definitions.__As used in this section, unless the context
otherwise indicates, the following terms have the following
meanings.

 
A.__"Outpatient care" means care rendered by a state-
licensed, approved or certified detoxification, residential
treatment or outpatient program, or partial hospitalization
program on a periodic basis, including, but not limited to,
patient diagnosis, assessment and treatment, individual,
family and group counseling and educational and support
services.

 
B.__"Residential treatment" means services at a facility
that provides care 24 hours daily to one or more patients,
including, but not limited to: room and board; medical,
nursing and dietary services; patient diagnosis, assessment
and treatment; individual, family and group counseling; and
educational and support services, including a designated
unit of a licensed health care facility providing any and
all other services specified in this paragraph to patients
with the illness of alcoholism or drug dependency.

 
C.__"Treatment plan" means a written plan initiated at the
time of admission, approved by a Doctor of Medicine, Doctor
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.

 
2.__Requirement.__A health maintenance organization that
issues individual and group 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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