LD 1954
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Page 2 of 7 An Act to Categorize Pervasive Developmental Disorder as a Neurological Disorde... Page 4 of 7
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LR 2464
Item 1

 
psychologist who is trained and has received a doctorate in
psychology specializing in the evaluation and treatment of
human behavior:

 
(1) Schizophrenia;

 
(2) Bipolar disorder;

 
(3) Pervasive developmental disorder, or autism;

 
(4) Paranoia;

 
(5) Panic disorder;

 
(6) Obsessive-compulsive disorder; or

 
(7) Major depressive disorder.

 
Sec. 5. 24-A MRSA §2749-D is enacted to read:

 
§2749-D.__Coverage of pervasive developmental disorder

 
1.__Mandated offer of coverage.__All individual insurance
policies and contracts must make available coverage providing, at
a minimum, benefits according to subsection 2, for a person
receiving treatment for pervasive developmental disorder, or
autism, diagnosed by a licensed allopathic or osteopathic
physician.

 
2.__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 reimbursing insurer, 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. 6. 24-A MRSA §2843, sub-§5-C, ķA, as amended by PL 1995, c. 637,
§4, is further amended to read:

 
A. All group contracts must provide, 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


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