WILLIAM DONALD SCHAEFER, Governor                               Ch. 2

(3) 30 outpatient visits at a certified alcoholism and drug abuse treatment
facility. Unless greater benefits are provided by the contract, the benefits for outpatient
visits during any calendar year or benefit period shall be equal to 100 percent of the cost
of care or $3,000, whichever is less.

(b)     Any group major medical contract, policy or certificate, including one issued
by a nonprofit health service plan, that provides benefits for both hospitalization and
medical care shall provide benefits equal to at least half those required by subsection (a)
of this section.

(c)      Under subsection (a) of this section, the total number of days and visits
combined may be limited to 120 during the covered person's lifetime. Unless greater
benefits are provided by the contract, the benefits under subsection (b) of this section
during any calendar year or benefit period shall be equal to 100 percent of the cost
required to be paid under subsection (b) or $3,000, whichever is less.

(d)     If the group contract issued by the insurer, including a nonprofit health
insurance plan, provides for the utilization review of the benefits required under
subsection (a) of this section, the private review agent performing the utilization review
shall meet the requirements of Title 19, Subtitle 13 of the Health - General Article.

(e)      For the purposes of this section, "drug abuse" has the meaning stated in §
8-101 of the Health - General Article.]

490V.

(A)     (1) IN THIS SECTION THE FOLLOWING TERMS HAVE THE MEANINGS
INDICATED.

(2)      "ALCOHOL ABUSE" HAS THE MEANING STATED IN § 8-101 OF THE
HEALTH - GENERAL ARTICLE.

(3)      "DRUG ABUSE" HAS THE MEANING STATED IN § 8-101 OF THE
HEALTH - GENERAL ARTICLE.

(4)      "MANAGED CARE SYSTEM" MEANS A METHOD THAT A CARRIER
USES TO REVIEW AND PREAUTHORIZE A TREATMENT PLAN THAT A HEALTH CARE
PRACTITIONER DEVELOPS FOR A COVERED PERSON USING A VARIETY OF COST
CONTAINMENT METHODS TO CONTROL UTILIZATION, QUALITY, AND CLAIMS.

(5)      "PARTIAL HOSPITALIZATION" MEANS THE PROVISION OF
MEDICALLY DIRECTED INTENSIVE OR INTERMEDIATE SHORT-TERM TREATMENT
FOR MENTAL ILLNESS, EMOTIONAL DISORDERS, DRUG ABUSE OR ALCOHOL ABUSE
FOR A PERIOD OF LESS THAN 24 HOURS BUT MORE THAN 4 HOURS IN A DAY FOR AN
INSURED, SUBSCRIBER OR MEMBER IN A LICENSED OR CERTIFIED FACILITY OR
PROGRAM.

(B)      (1) SUBJECT TO THE PROVISIONS OF THIS SECTION, EACH CONTRACT
OR POLICY OF HEALTH INSURANCE DELIVERED OR ISSUED FOR DELIVERY WITHIN
THIS STATE TO AN EMPLOYER OR AN INDIVIDUAL ON A GROUP OR INDIVIDUAL
BASIS THAT PROVIDES COVERAGE FOR HEALTH CARE ON AN EXPENSE-INCURRED
BASIS MAY NOT DISCRIMINATE AGAINST ANY PERSON WITH A MENTAL ILLNESS,

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