LD 1319
pg. 398
Page 397 of 423 An Act Making Unified Appropriations and Allocations for the Expenditures of St... Page 399 of 423
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LR 2000
Item 1

 
(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 or
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 and other drug
dependencies through the diagnosis of a mental illness listed
in paragraph A.

 
Sec. VV-21. 24-A MRSA §4234-A, sub-§7, as amended by PL 1995, c. 637,
§7, is further amended to read:

 
7. Mandated offer of coverage for certain mental illnesses.
Except as provided in subsection 6, coverage for medical or
psychiatric treatment for mental illnesses listed in paragraph
A by all individual and group 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:

 
(1) Schizophrenia;

 
(2) Bipolar disorder;

 
(3) Pervasive developmental disorder, or autism;


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