This bill requires insurers and health maintenance organizations that provide individual and group health coverage to provide coverage for outpatient counseling services when those services are provided by a licensed counseling professional acting within the lawful scope of the counseling professional's license, including a master social worker, clinical social worker, clinical professional counselor, pastoral counselor or marriage and family therapist. The bill requires these counseling professionals to be reimbursed, at a minimum, in an amount equal to 150% of the MaineCare reimbursement rate for the same services. The bill also prohibits discrimination against a licensed counseling professional or an arbitrary reduction in reimbursement rates based solely on the type of license held by a
43 licensed counseling professional. The bill prohibits the imposition of prior authorization or
44 referral requirements as a condition of coverage for outpatient counseling services or the
45 imposition of any restriction or limitation on access to outpatient counseling services that
46 does not have a clinical basis. The bill also requires that insurers and health maintenance
47 organizations maintain an adequate network of licensed counseling professionals to ensure
48 reasonable access to outpatient counseling services. The requirements apply beginning
49 January 1, 2026.

Statutes affected:
Bill Text LD 1589, HP 1047: 24-A.2744, 24-A.2835, 24-A.4234