LD 566
pg. 19
Page 18 of 20 An Act to Ensure Equality in Mental Health Coverage Page 20 of 20
Download Bill Text
LR 22
Item 1

 
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 individual or group contract.

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

 
Sec. 22. 24-A MRSA §4234-A, sub-§8, as enacted by PL 1995, c. 407,
§10, is amended to read:

 
8. Contracts; providers. Subject to approval by the
superintendent pursuant to section 4204, a health maintenance
organization incorporated under this chapter shall allow
providers, including those listed in subsection 8-A or
sections 2744 or 2835, subsection 1, to contract, subject to
the health maintenance organization's credentialling policy,
for the provision of mental health services within the scope
of the provider's licensure.

 
Sec. 23. 24-A MRSA §4234-A, sub-§8-A, as enacted by PL 1997, c. 174,
§1, is amended to read:

 
8-A. Mental health services provided by counseling
professionals. A health maintenance organization that issues
individual or group health care contracts providing coverage
for mental health services shall offer provide coverage for
those services when performed by a counseling professional who
is licensed by the State pursuant to Title 32, chapter 119 to
assess and treat interpersonal and intrapersonal problems, has
at least a masters degree in counseling or a related field
from an accredited educational institution and has been
employed as counselor for at least 2 years. Any contract
providing coverage for the services of counseling
professionals pursuant to this subsection may be subject to
any reasonable limitations, maximum benefits, coinsurance,
deductibles or exclusion provisions applicable to overall
benefits under the contract. This subsection applies to all
contracts executed, delivered, issued for delivery, continued
or renewed in this State on or after January 1, 1998. For
purposes of this subsection, all contracts are deemed renewed
no later than the next yearly anniversary of the contract
date.

 
Sec. 24. 24-A MRSA §4234-A, sub-§11, as amended by PL 1995, c. 673,
Pt. D, §8, is further amended to read:

 
11. Application. Except as otherwise provided, the
requirements of this section apply to all policies, contracts
and


Page 18 of 20 Top of Page Page 20 of 20