| | (7) Major depressive disorder.; or |
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| | | Any person birth to 18 years of age with a mental health | | condition that falls under any of the diagnostic categories | | listed in the mental disorders section of the Diagnostic and | | Statistical Manual of Mental Health Disorders, 4th Edition, | | DMS 4, as periodically revised, is covered under this | | paragraph. |
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| | | B. All policies, contracts and certificates executed, | | delivered, issued for delivery, continued or renewed in this | | State on or after July 1, 1996 must provide benefits that | | meet the requirements of this paragraph. For purposes of | | this paragraph, all contracts are deemed renewed no later | | than the next yearly anniversary of the contract date. |
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| | (1) The contracts must provide benefits for the | treatment and diagnosis of mental illnesses under terms | and conditions that are no less extensive than the | benefits provided for medical treatment for physical | illnesses. A health insurance plan must provide | | coverage for treatment of a mental health condition and | | may not establish a rate, term or condition that places | | a greater financial burden on an insured for access to | | treatment for a mental health condition than for access | | to treatment for a physical health condition.__Any | | deductible or out-of-pocket limits required under a | | health insurance plan must be comprehensive for | | coverage of both mental health and physical health | | conditions. |
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| | | (2) At the request of a nonprofit hospital or medical | | service organization, a provider of medical treatment | | for mental illness shall furnish data substantiating | | that initial or continued treatment is medically | | necessary and appropriate. When making the | | determination of whether treatment is medically | | necessary and appropriate, the provider shall use the | | same criteria for medical treatment for mental illness | | as for medical treatment for physical illness under the | | group contract. |
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| | | C.__A health insurance plan that does not otherwise provide for | | management of care under the plan or that does not provide for | | the same degree of management of care for all |
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