LD 1319
pg. 425
Page 424 of 460 PUBLIC Law Chapter 20 Page 426 of 460
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LR 2000
Item 1

 
B. All individual policies and contracts 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 insurer, 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 individual
policy.

 
This subsection may not be construed to allow coverage and
benefits for the treatment of alcoholism or other drug
dependencies through the diagnosis of a mental illness listed in
paragraph A.

 
Sec. VV-9. 24-A MRSA §2749-C, sub-§2, as enacted by PL 1995, c. 407,
§5, is amended to read:

 
2. Contracts; providers. Subject to approval by the
superintendent pursuant to section 2305, an An insurer
incorporated under this chapter shall offer contracts to
providers authorizing the provision of mental health services
within the scope of the provider's licensure.

 
Sec. VV-10. 24-A MRSA §2843, sub-§3, ¶¶A-1 and A-2 are enacted to read:

 
A-1.__"Diagnostic and statistical manual" means the
Diagnostic and Statistical Manual of Mental Disorders, 4th
edition, published by the American Psychiatric Association.

 
A-2.__"Home health care services" means those services
rendered by a licensed provider of mental health services to
provide medically necessary health care to a person


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