LD 566
pg. 5
Page 4 of 20 An Act to Ensure Equality in Mental Health Coverage Page 6 of 20
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LR 22
Item 1

 
illness and may not be counted in the calculation of
any maximum outpatient treatment visit limits.

 
This subsection does not apply to policies, contracts and
certificates covering employees of employers with 20 or fewer
employees, whether the group policy is issued to the employer,
to an association, to a multiple-employer trust or to another
entity.

 
This subsection may not be construed to allow coverage and
benefits for the treatment of alcoholism or other drug
dependencies through the diagnosis of a mental illness listed
in paragraph A .

 
Sec. 6. 24 MRSA §2325-A, sub-§5-D, as amended by PL 1995, c. 637,
§2, is further amended to read:

 
5-D. Mandated offer of coverage for certain mental
illnesses. Except as otherwise provided, coverage for medical
or psychiatric treatment for mental illnesses listed in
paragraph A by all individual and group nonprofit hospital and
medical services service organization health care plan
contracts is subject to this subsection.

 
A. All individual and group contracts must make available
coverage providing, at a minimum, benefits according to
paragraph B, subparagraph (1) for a person receiving
medical or psychiatric 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:

 
(1) Schizophrenia;

 
(2) Bipolar disorder;

 
(3) Pervasive developmental disorder, or autism;

 
(4) Paranoia;

 
(5) Panic disorder;

 
(6) Obsessive-compulsive disorder; or

 
(7) Major depressive disorder.

 
B. Every nonprofit hospital and medical services service
organization and nonprofit health care plan must make
available coverage in all individual and group policies,
contracts and certificates executed, delivered, issued for


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