LD 1472
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LD 1472 Title Page An Act to Clarify Reimbursement for Cognitive Services Page 2 of 3
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LR 2209
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 22 MRSA §3174-U is enacted to read:

 
§3174-U.__Coverage for cognitive services

 
The department shall provide coverage for cognitive services,
reimbursed under the United States Social Security Act, Title
XIX, or its successor, if the cognitive services are recommended
by a licensed physician for persons with schizophrenia.__
Cognitive services covered under this section may be provided by
a licensed physician, pharmacist, clinical social worker,
clinical professional counselor or other health care provider if
the services are within the scope of the provider's license.

 
Sec. 2. 24 MRSA §2332-J is enacted to read:

 
§2332-J. Coverage for cognitive services

 
1.__Required coverage for cognitive services.__Notwithstanding
any other provisions of this chapter, a nonprofit hospital or
medical service organization that issues group and individual
health care contracts__shall provide coverage under those
contracts for cognitive services recommended by a licensed
physician for persons with schizophrenia.__Cognitive services
covered under this section may be provided by a licensed
physician, pharmacist, clinical social worker, clinical
professional counselor or other health care provider if the
services are within the scope of the provider's license.

 
2.__Limits; coinsurance; deductibles.__Any 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.

 
Sec. 3. 24-A MRSA §2756 is enacted to read:

 
§2756. Coverage for cognitive services

 
1.__Required coverage for cognitive services.__Notwithstanding
any other provisions of this chapter, an insurer that issues
individual health insurance policies and contracts shall provide
coverage under those contracts for cognitive services recommended
by a licensed physician for persons with schizophrenia.__
Cognitive services covered under this section may be provided by
a licensed physician, pharmacist, clinical social worker,
clinical professional counselor or other health care


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