| | | 7. Mandated offer of coverage for certain mental illnesses. | | Except as provided in subsection 6, coverage for medical or | | psychiatric treatment for mental illnesses listed in paragraph | | A by all individual and group contracts is subject to this | | subsection. |
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| | | A. All individual and 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: |
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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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| | | B. All individual and group policies, contracts and | | certificates executed, delivered, issued for delivery, | continued or renewed in this State on or after July 1, | 1996 must make available coverage providing 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 offer of coverage 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 reimbursing health maintenance | | organization, 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 |
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