|
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. 6. 24 MRSA §2325-A, sub-§5-D, as amended by PL 1995, c. 637, | §2, is further amended to read: |
|
| | 5-D. Mandated offer of coverage for certain mental | illnesses. Except as otherwise provided, coverage for medical | or psychiatric treatment for mental illnesses listed in | paragraph A by all individual and group nonprofit hospital and | medical services service organization health care plan | contracts is subject to this subsection. |
|
| 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: |
|
| (3) Pervasive developmental disorder, or autism; |
|
| (6) Obsessive-compulsive disorder; or |
|
| (7) Major depressive disorder. |
|
| B. Every nonprofit hospital and medical services service | organization and nonprofit health care plan must make | available coverage in all individual and group policies, | contracts and certificates executed, delivered, issued for |
|
|