| | | 3.__Parity coverage.__An individual and group 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 a health | | maintenance organization, 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 health | | maintenance organization shall provide written notification to | | all individuals eligible for benefits under individual and group | | 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, a health maintenance organization 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 individual and group health care contracts, | | separated according to those paid for inpatient or outpatient | | services.__The superintendent shall compile this data for all | | insurers in an annual report. |
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| | | 8.__Application. The requirements of this section apply to | | policies, certificates or contracts executed, delivered, issued | | for delivery, continued or renewed in this State on or after | | January 1, 2000.__For purposes of this section, a contract is | | deemed to be renewed no later than the next yearly anniversary of | | the contract date. |
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