Maine § 24-A §2749-C Mental health services coverage

Maine Statutes

§ 24-A §2749-C — Mental health services coverage

Maine·Title 24-A MAINE INSURANCE CODE·Ch. 33 HEALTH INSURANCE CONTRACTS

1.Coverage for treatment for certain mental illnesses. Coverage for medical treatment for mental illnesses listed in paragraph A‑1 by all individual policies is subject to this section.

2.Contracts; providers. An insurer incorporated under this chapter shall offer contracts to providers authorizing the provision of mental health services within the scope of the provider's licensure.

3.Limits; coinsurance; deductibles. A policy or contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.

4.Reports to the superintendent. Every insurer subject to this section shall

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1.
Coverage for treatment for certain mental illnesses.
Coverage for medical treatment for mental illnesses listed in paragraph A‑1 by all individual policies is subject to this section.
2.
Contracts; providers.
An insurer incorporated under this chapter shall offer contracts to providers authorizing the provision of mental health services within the scope of the provider's licensure.
3.
Limits; coinsurance; deductibles.
A policy or contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.
4.
Reports to the superintendent.
Every insurer subject to this section shall report its experience for each calendar year to the superintendent no later than April 30th of the following year. The report must be in a form prescribed by the superintendent and include the amount of claims paid in this State for the services required by this section and the total amount of claims paid in this State for individual health care policies, both separated according to those paid for inpatient, day treatment and outpatient services. The superintendent shall compile this data for all insurers in an annual report.
5.
Application.
Except as otherwise provided, the requirements of this section apply to all policies and contracts executed, delivered, issued for delivery, continued or renewed in this State on or after July 1, 1996. For purposes of this section, all policies are deemed renewed no later than the next yearly anniversary of the contract date. Nothing in this section applies to accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance policies.

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Legislative History

PL 1995, c. 407, §5 (NEW). PL 1995, c. 637, §3 (AMD). PL 2003, c. 20, §§VV8,9 (AMD). PL 2003, c. 20, §VV25 (AFF). PL 2019, c. 5, Pt. D, §1 (AMD). PL 2021, c. 595, §§1, 2 (AMD).