Maine Revised Statutes Title 24-A Sec. 4258 – Coverage for children’s early intervention services
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1. Definition. For purposes of this section, “children’s early intervention services” means services provided by licensed occupational therapists, physical therapists, speech-language pathologists or clinical social workers working with children from birth to 36 months of age with an identified developmental disability or delay as described in the federal Individuals with Disabilities Education Act, Part C, 20 United States Code § 1411, et seq.
[PL 2009, c. 634, §4 (NEW); PL 2009, c. 634, §5 (AFF).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4258
- Contract: A legal written agreement that becomes binding when signed.
- Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
A. See Maine Revised Statutes Title 24-A Sec. 4202-AProvider: means a physician, hospital or person that is licensed or otherwise authorized in this State to furnish health care services. See Maine Revised Statutes Title 24-A Sec. 4202-A United States: includes territories and the District of Columbia. See Maine Revised Statutes Title 1 Sec. 72 Year: means a calendar year, unless otherwise expressed. See Maine Revised Statutes Title 1 Sec. 72
2. Required coverage. All individual and group health maintenance organization policies, contracts and certificates must provide coverage for children’s early intervention services in accordance with this subsection.
A. A referral from the child’s primary care provider is required. [PL 2009, c. 634, §4 (NEW); PL 2009, c. 634, §5 (AFF).]
B. The policy, contract or certificate may limit coverage to $3,200 per year for each child not to exceed $9,600 by the child’s 3rd birthday. [PL 2009, c. 634, §4 (NEW); PL 2009, c. 634, §5 (AFF).]
C. The policy, contract or certificate 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. [PL 2009, c. 634, §4 (NEW); PL 2009, c. 634, §5 (AFF).]
[PL 2009, c. 634, §4 (NEW); PL 2009, c. 634, §5 (AFF).]
Revisor’s Note: §4258. Coverage for the diagnosis and treatment of autism spectrum disorders (As enacted by PL 2009, c. 635, §4; §6 is REALLOCATED TO TITLE 24-A, SECTION 4259)
SECTION HISTORY
PL 2009, c. 634, §4 (NEW). PL 2009, c. 634, §5 (AFF). PL 2009, c. 635, §4 (NEW). PL 2009, c. 635, §6 (AFF). PL 2011, c. 420, Pt. A, §27 (RAL).