LD 1319
pg. 393
Page 392 of 423 An Act Making Unified Appropriations and Allocations for the Expenditures of St... Page 394 of 423
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LR 2000
Item 1

 
Sec. VV-15. 24-A MRSA §2843, sub-§5-D, as amended by PL 1995, c. 637,
§5, is further amended to read:

 
5-D. Mandated offer of coverage for certain mental
illnesses. Except as otherwise provided in subsection 5-C,
coverage for medical or psychiatric treatment for mental
illnesses listed in paragraph A by all group contracts is
subject to this subsection.

 
A. All 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:

 
(1) Schizophrenia;

 
(2) Bipolar disorder;

 
(3) Pervasive developmental disorder, or autism;

 
(4) Paranoia;

 
(5) Panic disorder;

 
(6) Obsessive-compulsive disorder; or

 
(7) Major depressive disorder.

 
B. All 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.

 
(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 reimbursing insurer, a provider of
medical or psychiatric treatment for mental illness shall
furnish data substantiating that initial or continued
treatment is medically or psychiatrically


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