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| | | (6) Obsessive-compulsive disorder; or |
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| | | (7) Major depressive disorder. |
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| | | B. 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 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. |
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| | | (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. |
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| | | (2) At the request of a reimbursing health | | maintenance 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. |
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| | | 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. |
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| | | Sec. VV-22. 24-A MRSA §4234-A, sub-§8, as enacted by PL 1995, c. 407, | | §10, is amended to read: |
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| | | 8. Contracts; providers. Subject to approval by the | | superintendent pursuant to section 4204, a health maintenance | | organization incorporated under this chapter shall allow | | providers, including those listed in subsection 8-A or | | sections 2744 or 2835, subsection 1, to contract, subject to | | the health maintenance organization's credentialling policy, | | for the | | provision of mental health services within the scope of the | | provider's licensure. |
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