LD 2055
pg. 16
Page 15 of 33 An Act To Correct Errors and Inconsistencies in the Laws of Maine Page 17 of 33
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LR 3065
Item 1

 
reimbursement for services that are within the lawful scope of
practice of a professional listed in subsection 2-A, any person
covered by the policy is entitled to reimbursement for these
services if the services are performed by a physician or a
professional listed in subsection 2-A.__Payment or reimbursement
for services rendered by a professional listed in subsection 2-A,
paragraph B, C, D, E or F may not be conditioned upon prior
diagnosis or referral by a physician or other health care
professional, except when diagnosis of the condition for which the
services are rendered is beyond the scope of their licensure.

 
2.__Nothing in subsection 1 may be construed to require a
health insurance policy subject to this chapter to provide for
reimbursement of services that are within the lawful scope of
practice of a professional listed in subsection 2-A.

 
2-A. Subsections 1 and 2 apply with respect to the following
types of professionals:

 
A.__A psychologist licensed to practice in this State;

 
B.__A certified social worker licensed for the independent
practice of social work in this State;

 
C.__A licensed clinical professional counselor licensed for
the independent practice of counseling in this State;

 
D.__A licensed nurse who is certified by the American
Nurses' Association as a clinical specialist in adult
psychiatric and mental health nursing or as a clinical
specialist in child and adolescent psychiatric and mental
health nursing;

 
E.__A marriage and family therapist licensed as a marriage
and family therapist in this State; and

 
F.__A licensed pastoral counselor licensed as a pastoral
counselor in this State.

 
3.__Mental health services provided by counseling
professionals.__Except as provided in subsection 1 with regard to
reimbursement of clinical professional counselors, pastoral
counselors and marriage and family therapists licensed in this
State, an insurer that issues group health care contracts
providing coverage for mental health services shall make
available 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 master's degree in
counseling or a related field from an accredited educational


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