LD 1319
pg. 399
Page 398 of 423 An Act Making Unified Appropriations and Allocations for the Expenditures of St... Page 400 of 423
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LR 2000
Item 1

 
(4) Paranoia;

 
(5) Panic disorder;

 
(6) Obsessive-compulsive disorder; or

 
(7) Major depressive disorder.

 
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.

 
(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 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.

 
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-22. 24-A MRSA §4234-A, sub-§8, as enacted by PL 1995, c. 407,
§10, is amended to read:

 
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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