| | | Sec. VV-15. 24-A MRSA §2843, sub-§5-D, as amended by PL 1995, c. 637, | | §5, is further amended to read: |
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| | | 5-D. Mandated offer of coverage for certain mental illnesses. | | Except as otherwise provided in subsection 5-C, coverage for | | medical treatment for mental illnesses listed in paragraph A by | | all group contracts is subject to this subsection. |
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| | | A. All group contracts must make available coverage | | providing, at a minimum, benefits according to paragraph B, | | subparagraph (1) for a person receiving medical treatment | | for any of the following mental illnesses 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 | human behavior mental illness: |
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| | | (3) Pervasive developmental disorder, or autism; |
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| | | (6) Obsessive-compulsive disorder; or |
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| | | (7) Major depressive disorder. |
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| | | B. All 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 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 |
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