Ch. 2

1994 LAWS OF MARYLAND

EMOTIONAL DISORDER OR A DRUG ABUSE OR ALCOHOL ABUSE DISORDER BY
FAILING TO PROVIDE BENEFITS FOR TREATMENT AND DIAGNOSIS OF THESE
ILLNESSES UNDER THE SAME TERMS AND CONDITIONS THAT APPLY UNDER THE
CONTRACT OR POLICY FOR TREATMENT OF PHYSICAL ILLNESS.

(2) IT SHALL NOT BE CONSIDERED TO BE DISCRIMINATORY UNDER
SUBSECTION (B)(1) OF THIS SECTION IF AT LEAST THE FOLLOWING BENEFITS ARE
PROVIDED:

(I)       WITH RESPECT TO INPATIENT BENEFITS PROVIDED IN A
LICENSED OR CERTIFIED FACILITY, WHICH SHALL INCLUDE HOSPITAL INPATIENT
BENEFITS, THE TOTAL NUMBER OF DAYS FOR WHICH BENEFITS ARE PAYABLE
SHALL BE:

1.        EXCEPT AS PROVIDED IN SUBSECTION (D) OF THIS
SECTION, FROM JULY 1, 1994 THROUGH JUNE 30, 1995, AT LEAST 60 DAYS IN ANY
CALENDAR YEAR OR A BENEFIT PERIOD OF NOT MORE THAN 12 MONTHS UNDER
THE SAME TERMS AND CONDITIONS THAT APPLY TO BENEFITS AVAILABLE UNDER
THE CONTRACT OR POLICY FOR PHYSICAL ILLNESS; AND

2.        ON OR AFTER JULY 1,1995, AT LEAST EQUAL TO THE SAME
TERMS AND CONDITIONS THAT APPLY TO THE BENEFITS AVAILABLE UNDER THE
CONTRACT OR POLICY FOR PHYSICAL ILLNESS;

(II)     SUBJECT TO SUBSECTION (F) OF THIS SECTION, WITH RESPECT
TO. BENEFITS FOR PARTIAL HOSPITALIZATION, AT LEAST 60 DAYS OF PARTIAL
HOSPITALIZATION SHALL BE COVERED UNDER THE SAME TERMS AND CONDITIONS
THAT APPLY TO THE BENEFIT AVAILABLE UNDER THE CONTRACT OR POLICY FOR
PHYSICAL ILLNESS; AND

(III)    WITH RESPECT TO OUTPATIENT COVERAGE, OTHER THAN FOR
INPATIENT OR PARTIAL HOSPITALIZATION SERVICES, BENEFITS FOR COVERED
EXPENSES ARISING FROM SERVICES WHICH ARE RENDERED TO TREAT MENTAL
ILLNESS, EMOTIONAL DISORDERS, DRUG ABUSE AND ALCOHOL ABUSE SHALL BE AT
A RATE WHICH IS, AFTER THE APPLICABLE DEDUCTIBLE, NOT LESS THAN:

1. 80 PERCENT FOR THE FIRST 5 VISITS IN ANY CALENDAR
YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12 MONTHS;

2. 65 PERCENT FOR THE 6TH TO THROUGH 30TH VISIT IN
ANY CALENDAR YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12 MONTHS; AND

3.        50 PERCENT FOR THE 31ST VISIT AND ANY VISIT AFTER
THE 31ST VISIT IN ANY CALENDAR YEAR OR BENEFIT PERIOD OF NOT MORE THAN 12
MONTHS.

(C) (1). THE BENEFITS UNDER THIS SECTION SHALL BE REQUIRED ONLY
FOR EXPENSES ARISING FOR TREATMENT OF MENTAL ILLNESSES, EMOTIONAL
DISORDERS, DRUG ABUSE AND ALCOHOL ABUSE WHICH IN THE PROFESSIONAL
JUDGMENT OF PRACTITIONERS IS MEDICALLY NECESSARY AND TREATABLE.

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