LD 1319
pg. 421
Page 420 of 460 PUBLIC Law Chapter 20 Page 422 of 460
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LR 2000
Item 1

 
(4)__Anxiety disorders;

 
(5)__Personality disorders;

 
(6)__Paraphilias;

 
(7)__Attention deficit and disruptive behavior
disorders;

 
(8)__Pervasive developmental disorders;

 
(9)__Tic disorders;

 
(10)__Eating disorders, including bulimia and anorexia;
and

 
(11)__Substance abuse-related disorders.

 
For the purposes of this paragraph, the mental illness must
be 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 mental illness.

 
B. All policies, contracts and certificates executed,
delivered, issued for delivery, continued or renewed in this
State on or after July 1, 1996 must provide 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 contracts 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 nonprofit hospital or and
medical service organization, a provider of medical
treatment for mental illness shall furnish data
substantiating that initial or continued treatment is
medically necessary and appropriate health care. When
making the determination of whether treatment is
medically necessary and appropriate health care, the
provider shall use the same criteria for medical
treatment for mental illness as for medical treatment
for physical illness under the group contract.


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