| | 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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| | 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. |
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| | | Sec. VV-16. 24-A MRSA §4234-A, sub-§3, ¶¶A-1 and A-2 are enacted to read: |
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| | | A-1. "Diagnostic and Statistical Manual" means the | | Diagnostic and Statistical Manual of Mental Disorders, 4th | | edition, published by the American Psychiatric Association. |
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| | | 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 | | suffering from a mental illness in the person's place of | | residence if: |
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| | | (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-17. 24-A MRSA §4234-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 section 4301-A, subsection 10-A. |
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| | | Sec. VV-18. 24-A MRSA §4234-A, sub-§3, ¶D, as enacted by PL 1995, c. | | 407, §10, 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 area of | | social, psychological or biological functioning. Such a |
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