LD 1319
pg. 436
Page 435 of 460 PUBLIC Law Chapter 20 Page 437 of 460
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LR 2000
Item 1

 
B. All individual and 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.

 
(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 health maintenance
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 individual or group contract.

 
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.

 
Sec. VV-22. 24-A MRSA §4234-A, sub-§8, as enacted by PL 1995, c. 407,
§10, is amended to read:

 
8. Contracts; providers. Subject to approval by the
superintendent pursuant to section 4204, a A health maintenance
organization incorporated under this chapter shall allow
providers to contract, subject to the health maintenance
organization's credentialling policy, for the provision of mental
health services within the scope of the provider's licensure.

 
Sec. VV-23. 24-A MRSA §4234-A, sub-§8-A, as enacted by PL 1997, c.
174, §1, is amended to read:

 
8-A. Mental health services provided by counseling
professionals. A health maintenance organization that issues
individual or group health care contracts providing coverage for
mental health services shall offer coverage for those services
when performed by a counseling professional who is licensed by
the State pursuant to Title 32, chapter 119 to assess and treat
interpersonal and intrapersonal problems, has at least a masters


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