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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. |
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| | (2) At the request of a nonprofit hospital or | medical service organization a reimbursing insurer, a | | provider of medical or psychiatric treatment for | | mental illness shall furnish data substantiating that | | initial or continued treatment is medically or | | psychiatrically necessary and appropriate. When | | making the determination of whether treatment is | | medically or psychiatrically necessary and | | appropriate, the provider shall use the same criteria | | for medical or psychiatric treatment for mental | | illness as for medical treatment for physical illness | | under the group contract. |
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| | | (3)__If benefits and coverage provided for treatment | | of physical illness are provided on an expense- | | incurred basis, the benefits and coverage required | | under this subsection may be delivered separately | | under a managed care system. |
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| | | (4)__A policy or contract may not have separate | | maximums for physical illness and mental illness, | | separate deductibles and coinsurance amounts for | | physical illness and mental illness, separate out-of- | | pocket limits in a benefit period of not more than 12 | | months for physical illness and mental illness or | | separate office visitation limits for physical | | illness and mental illness. |
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| | | (5)__A health benefit plan may not impose a | | limitation on coverage or benefits for mental illness | | unless that same limitation is also imposed on the | | coverage and benefits for physical illness covered | | under the policy or contract. |
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| | | (6)__Copayments required under a policy or contract for | | benefits and coverage for mental illness must be actuarially | | equivalent to any coinsurance requirements |
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