Sec. 3. 24 MRSA §2325-D is enacted to read:

§2325-D.__Coverage of pervasive developmental disorder

1.__Mandated offer of coverage.__Except as otherwise provided in subsection 2, all individual and group nonprofit hospital and medical service organization plan contracts and all nonprofit health care service organization plan contracts must make available coverage providing, at a minimum, benefits according to subsection 3, for a person receiving treatment for pervasive developmental disorder, or autism, diagnosed by a licensed allopathic or osteopathic physician.

2.__Mandated benefit.__All group nonprofit hospital and medical service organization plan contracts and all nonprofit health care service organization plan contracts must provide, at a minimum, benefits according to subsection 3, for a person receiving treatment for pervasive developmental disorder, or autism, diagnosed by a licensed allopathic or osteopathic physician.__This subsection does not apply to policies, contracts and certificates covering employees of employers with fewer than 20 employees, whether the group policy is issued to the employer, to an association, to a multiple-employer trust or to another entity.

3.__Minimum benefits.__The contracts must provide benefits for the treatment and diagnosis of pervasive developmental disorder, or autism, under terms and conditions that are no less extensive than the benefits provided for medical treatment for physical illnesses.__At the request of a nonprofit hospital or medical service organization, a provider of medical treatment for pervasive developmental disorder, or autism, 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 pervasive developmental disorder, or autism, as for medical treatment for physical illness under the contract.

Sec. 4. 24-A MRSA §2749-C, sub-§1, ķA, as amended by PL 1995, c. 637, §3, is further amended to read:

A. All individual policies must make available coverage providing, at a minimum, benefits according to paragraph B, subparagraph (1) for a person receiving medical treatment for any of the following mental illnesses diagnosed by a licensed allopathic or osteopathic physician or a licensed