An Act To Require That Mental Health Workers with LCPC Licenses Are Recognized as Licensed Professionals for Purposes of Insurance Reimbursement
Maine Legislature, Session 121, LD 0563
Committee: Insurance and Financial Services
Sponsors: GLYNN
Amends: 24-A MRSA §2835, 24-A MRSA §4234-A

Legislative Document 
No. 563 
H.P.426 
House of Representatives, February 6, 2003 
An Act To Require That Mental Health Workers with LCPC 
Licenses Are Recognized as Licensed Professionals for Purposes of 
Insurance Reimbursement 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative GLYNN of South Portland. 
Printed on recycled paper 
/Jf~ 
/J1.1Jld£~ 
MILLICENT M. MacFARLAND 
Clerk 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24·A MRSA §2744, as amended by PL 1995, c. 561, §2, 
is further amended to read: 
§2744. Mental health services 
1. 
Notwithstanding 
any provision of 
a 
health insurance 
policy subject to this chapter, whenever the policy provides for 
payment or reimbursement for services wl:iiel:i ~ 
are within the 
lawful scope of practice of a psychologist licensed to practice 
in this StateTL 
a 
certified social 
worker 
licensed for 
the 
independent practice of social work in this State who has at 
least 
a 
masters 
degree 
in 
social 
work 
from 
an 
accredited 
educational institution, has been employed in social work for at 
least 2 years, and who, after January 1, 1985, must be licensed 
as a clinical social worker in this StateT; a licensed clinical 
professional counselor licensed for the independent practice of 
counseling who has at least a masters degree in counseling from 
an 
accredited educational 
institution, 
has 
been 
employed 
in 
counseling for at least 2 years and, after January 1, 2002, must 
be licensed as a clinical professional counselor in this State, 
or a 
licensed nurse who is certified by the American Nurses' 
Association as a clinical specialist in adult psychiatric and 
mental health nursing or as a clinical specialist in child and 
adolescent psychiatric and mental health nursing, 
any person 
covered by the policy sl:ial-l--ee is entitled to reimbursement for 
these services if the services are performed by a physicianrL a 
psychologist licensed to practice in this StateTL a certified 
social worker licensed for the independent practice of social 
work who has at least a masters degree in social work from an 
accredited educational institution, 
who 
has 
been 
employed 
In 
social work for at least 2 years, and who, after January 1, 1985, 
must be licensed as a clinical social worker in this StaterL-.Q 
licensed 
clinical 
professional 
counselor 
licensed 
for 
the 
independent practice of counseling who has at least a masters 
degree in counseling from an accredited educational institution, 
has been employed in counseling for at least 2 years and, after 
January 1, 
2002, 
must be licensed as 
a clinical professional 
counselor in this State; or a licensed nurse certified by the 
American Nurses' Association as a clinical specialist in adult or 
child and adolescent psychiatric and mental health nursing. 
Wi~l:i 
~e6pee~-£e-~~¥~€~-~~~~~~~~r-p&yel:iel-~i&~&r-~l:iis 
see~ieR--~~~-~-a~~-~l~~-iR&QFaRee-¥B~~€~~~-~~r~~~-er 
ee~~i€iea~es--~££~e47--~~--~~~~,--~~~~r--ameaGe4--e~ 
reissQea-e~-~-~~~-~~~-l-r-±g+§T Payment or reimbursement for 
services rendered by clinical social workers licensed in this 
State sl:ia±±, 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 
Page l-LR0764(l) 
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. 
2. 
Nothing in subsection 1 may be construed to require a 
health insurance policy subject to this chapter to provide for 
reimbursement of services waiea ~ 
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 to practice in this State, 
a 
certified social worker licensed to practice in this State, or a 
certified nurse licensed to practice in this State. 
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Sec. 2. 24-A MRSA §2835, as amended by PL 1995, c. 561, §3, 
is further amended to read: 
§2835. Mental health services 
1. 
Notwithstanding any provision of 
a 
health insurance 
policy subject to this chapter, whenever the policy provides for 
payment or reimbursement for services waiea ~ 
are within the 
lawful scope of practice of a psychologist licensed to practice 
in this StateTL 
a 
certified social worker 
licensed for 
the 
independent practice of social work in this State who has at 
least 
a 
masters 
degree 
in 
social 
work 
from 
an 
accredited 
educational institution, has been employed in social work for at 
least 2 years, and who, after January 1, 1985, must be licensed 
as a clinical social worker in this StateT; a licensed clinical 
professional counselor licensed for the independent practice of 
counseling who has at least a masters degree in counseling from 
an 
accredited educational 
institution, 
has 
been 
employed 
in 
counseling for at least 2 years and, after January 1, 2002, must 
be licensed as a clinical professional counselor in this State; 
or a 
licensed nurse who is certified by the American Nurses' 
Association as a clinical specialist in adult psychiatric and 
mental health nursing or as a clinical specialist in child and 
adolescent psychiatric 
and mental health nursing, 
any person 
covered by the policy saall-ae li entitled to reimbursement for 
these services if the services are performed by a physicianTL a 
psychologist licensed to practice in this 
StateT~ certified 
social worker licensed for independent practice in this State who 
has at least a masters degree in social work from an accredited 
educational institution, who has been employed in social work for 
at least 2 
years, 
and 
who, 
after January 1, 
1985, 
must 
be 
licensed as a clinical social worker in this StateT; a licensed 
clinical professional 
counselor 
licensed 
for 
the 
independent 
practice of counseling who has at least a 
masters degree in 
counseling from an accredited educational institution, has been 
employed in counseling for at least 2 years and, after January 1, 
2002, must be licensed as a clinical professional counselor in 
this State; or a licensed nurse certified by the American Nurses' 
Association 
as 
a 
clinical specialist in adult or 
child 
and 
adolescent psychiatric and mental health nursing. 
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Payment or reimbursement 
for services rendered by clinical social workers licensed in this 
State saall, 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. 
2. 
Nothing in subsection 1 may be construed to requi re a 
health insurance policy subject to this chapter to provide for 
reimbursement of services waiea 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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Sec. 3. 24-A MRSA §4234-A, sub-§8, as enac ted by PL 1995, c. 
407, §10, is amended to read: 
8. 
Contracts; 
providers. 
Subject 
to 
approval 
by 
the 
superintendent pursuant to section 4204, 
a health maintenance 
organization 
incorporated 
under 
this 
chapter 
shall 
allow 
providers, pursuant to sections 2744 and 2835, to contract for 
and 
receive 
payment, 
subject 
to 
the 
health 
maintenance 
organization's credentialling policy. for the provision of mental 
health services within the scope of the provider's licensure. 
Sec. 4. 
Application. 
This 
Act 
applies 
to 
all 
policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State on or after January 
1, 2004. 
For purposes of this Act, all contracts are deemed to 
be 
renewed no later than the next yearly anniversary of the 
contract date. 
SUMMARY 
This bill mandates that all health care plans reimburse 
licensed 
clinical 
professional 
counselors 
for 
mental 
health 
services. 
The bill applies to all policies and contracts issued 
or renewed on or after January 1, 2004.