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services provided by physicians or psychologists, this section | applies to all health insurance policies, contracts or certificates | issued, renewed, modified, altered, amended or reissued on or after | April 16, 1976. Payment or reimbursement for services rendered by | clinical social workers licensed in this State shall, licensed | | clinical professional counselors licensed in this State or licensed | | nurses certified by the American Nurses' Association as clinical | | specialists in adult or child and adolescent psychiatric and mental | | health nursing may not be conditioned upon prior diagnosis or | | referral by a physician or other health care professional, except | | in cases where diagnosis of the condition for which the services | | are rendered is beyond the scope of their licensure. |
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| | | 2. Nothing in subsection 1 may be construed to require a | | health insurance policy subject to this chapter to provide for | reimbursement of services which that are within the lawful scope | | of practice of a psychologist licensed to practice in this State, | | a clinical social worker licensed in this State, a clinical | | professional counselor licensed in this State, a certified social | | worker licensed to practice in this State, or a nurse certified | | and licensed to practice in this State. |
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| | | 3. Mental health services provided by counseling | professionals. An Except as provided in subsection 1 with regard | | to reimbursement of clinical professional counselors 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 masters degree in | | counseling or a related field from an accredited educational | | institution and has been employed as a counselor for at least 2 | | years. Any contract providing coverage for the services of | | counseling professionals pursuant to this section may be subject | | to any reasonable limitations, maximum benefits, coinsurance, | | deductibles or exclusion provisions applicable to overall | | benefits under the contract. This subsection applies to all | | contracts executed, delivered, issued for delivery, continued or | | renewed in this State on or after January 1, 1997. For purposes | | of this subsection, all contracts are deemed renewed no later | | than the next yearly anniversary of the contract date. |
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| | | Sec. 3. 24-A MRSA §4234-A, sub-§8, as amended by PL 2003, c. 20, Pt. | | VV, §22 and affected by §25, is further amended to read: |
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| | | 8. Contracts; providers. A health maintenance organization | | incorporated under this chapter shall allow |
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