| | | (1)__Hospitalization or confinement in a residential | | treatment facility would otherwise have been required | | if home health care services were not provided; |
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| | | (2)__Hospitalization or confinement in a residential | | treatment facility is not required as an antecedent to | | the provision of home health care services; and |
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| | | (3)__The services are prescribed in writing 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 mental illness. |
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| | | Sec. VV-2. 24 MRSA §2325-A, sub-§3, ¶B-1 is enacted to read: |
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| | | B-1. "Medically necessary health care" has the same meaning | | as in Title 24-A, section 4301-A, subsection 10-A. |
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| | | Sec. VV-3. 24 MRSA §2325-A, sub-§3, ¶D, as enacted by PL 1983, c. 515, | | §4, is amended to read: |
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| | D. "Person suffering from a mental or nervous condition | | illness" means a person whose psychobiological processes are | | impaired severely enough to manifest problems in the areas | | of social, psychological or biological functioning. Such a | | person has a disorder of thought, mood, perception, | orientation or memory which that impairs judgment, behavior, | | capacity to recognize or ability to cope with the ordinary | | demands of life. The person manifests an impaired capacity | | to maintain acceptable levels of functioning in the areas of | | intellect, emotion or physical well-being. |
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| | | Sec. VV-4. 24 MRSA §2325-A, sub-§§4 and 5, as enacted by PL 1983, c. | | 515, §4, are amended to read: |
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| | | 4. Requirement. Every nonprofit hospital or and medical | service organization which that issues group health care | contracts providing coverage for hospital care to residents of | | this State shall provide benefits as required in this section to | | any subscriber or other person covered under those contracts for | | conditions arising from mental illness. |
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| | | 5. Services. Each group contract shall must provide, at a | minimum for medically necessary health care for a person | | suffering from mental illness.__Medically necessary health care | includes, but is not limited to, for the following benefits | services for a person suffering from a mental or nervous | condition illness: |
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