LD 566
pg. 12
Page 11 of 20 An Act to Ensure Equality in Mental Health Coverage Page 13 of 20
Download Bill Text
LR 22
Item 1

 
or, if there are no coinsurance requirements, not
greater than any copayment required under the policy
or contract for a benefit or coverage for a physical
illness.

 
(7)__For the purposes of this section, medication
management visits associated with a mental illness
must be covered in the same manner as a medication
management visit for the treatment of a physical
illness and may not be counted in the calculation of
any maximum outpatient treatment visit limits.

 
This subsection does not apply to policies, contracts and
certificates covering employees of employers with 20 or fewer
employees, whether the group policy is issued to the employer,
to an association, to a multiple-employer trust or to another
entity.

 
This subsection may not be construed to allow coverage and
benefits for the treatment of alcoholism or other drug
dependencies through the diagnosis of a mental illness listed
in paragraph A.

 
Sec. 15. 24-A MRSA §2843, sub-§5-D, as amended by PL 1995, c. 637,
§5, is further amended to read:

 
5-D. Mandated offer of coverage for certain mental
illnesses. Except as otherwise provided in subsection 5-C,
coverage for medical or psychiatric treatment for mental
illnesses listed in paragraph A by all group contracts is
subject to this subsection.

 
A. All group contracts must make available coverage
providing, at a minimum, benefits according to paragraph
B, subparagraph (1) for a person receiving medical or
psychiatric treatment for any of the following mental
illnesses diagnosed by a licensed allopathic or
osteopathic physician or, a licensed psychologist who is
trained and has received a doctorate in psychology
specializing in the evaluation and treatment of human
behavior mental illness:

 
(1) Schizophrenia;

 
(2) Bipolar disorder;

 
(3) Pervasive developmental disorder, or autism;

 
(4) Paranoia;

 
(5) Panic disorder;


Page 11 of 20 Top of Page Page 13 of 20