(6)__Paraphilias;

(7)__Attention deficit and disruptive behavior disorders;

(8)__Pervasive developmental disorders;

(9)__Tic disorders;

(10)__Eating disorders, including bulimia and anorexia; and

(11)__Substance abuse-related disorders.

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.

(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.

(2) At the request of a nonprofit hospital or and medical service 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 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.

(3)__If benefits and coverage 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.

(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.

(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.

(6)__Copayments required under a policy or contract for benefits and coverage for mental illness must be actuarially equivalent to any coinsurance requirements 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. VV-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