| | |
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 | delivery, continued or renewed in this State on or after | July 1, 1996 that provides benefits meeting 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 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. |
|
| | (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 individual or group | | contract. |
|
| | | This subsection may not be construed to allow coverage and | | benefits for the treatment of alcoholism or other drug |
|
|