| | | 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. |
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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 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. |
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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-22. 24-A MRSA §4234-A, sub-§8, as enacted by PL 1995, c. 407, | | §10, is amended to read: |
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| | | 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. |
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| | | Sec. VV-23. 24-A MRSA §4234-A, sub-§8-A, as enacted by PL 1997, c. | | 174, §1, is amended to read: |
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| | | 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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