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psychologist who is trained and has received a doctorate in | | psychology specializing in the evaluation and treatment of | | human behavior: |
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| | (3) Pervasive developmental disorder, or autism; |
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| | | (6) Obsessive-compulsive disorder; or |
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| | | (7) Major depressive disorder. |
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| | | Sec. 5. 24-A MRSA §2749-D is enacted to read: |
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| | | §2749-D.__Coverage of pervasive developmental disorder |
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| | | 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. |
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| | | 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. |
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| | | Sec. 6. 24-A MRSA §2843, sub-§5-C, ķA, as amended by PL 1995, c. 637, | | §4, is further amended to read: |
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| | | 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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