An Act To Require That Licensed Pastoral Counselors Be Recognized as Licensed Professionals for Purposes of Insurance Reimbursement
Maine Legislature, Session 122, LD 0027
Committee: Insurance and Financial Services
Sponsors: GLYNN
Amends: 24-A MRSA §2744, 24-A MRSA §2835

Legislative Document 
No. 27 
H.P.30 
House of Representatives, January 6, 2005 
An Act To Require That Licensed Pastoral Counselors Be 
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 
1r/~/J7.~ 
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 2003, c. 65, §1 and 
affected by §5, is further ~mended 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 that are within the lawful 
scope of practice of a psychologist licensed to practice in this 
State; 
a certified social worker licensed for the independent 
practice of social work in this State wRe-Ra£-~--~-a-ffias~e~s 
ae~~ee-iR-£~~a~-~~-~~~~-a&&~~~-eaHea~ieaa±-ias~i~~~ieBT 
Ras-~~~-~~-~a-seeia*-we~~-~~--a~-*eas~-~-~~,--aaG-wRer 
aE~e~-~~-~7--~~S~r-~--Be--~~-a£--a-~~~~~--seeia± 
we~*e~-~~~~~-S~a~e; a licensed clinical professional counselor 
licensed for the independent practice of counseling wRe--ha-s--alo 
*eas~--~-~&~~&--ae~£ee--~~--eeHa&e±ia~--~~em--~--aee~eailoee 
.ea~ea~ieBa*-~~~~~~~--&a&-eeeR-~l~-ia-£e~~£~~~~~-~~~-a\o 
*eas~-~-~~-aaGr-a~te~-Ja~~a~y-~~--~br-ffi~S~-~-~~~-a&-a 
e*iBiea±--~£eEessieBa±--ee~Rse*e~ in 
this 
Stater; 
a 
licensed 
pastoral counselor licensed as a pastoral counselor in the 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 is entitled to reimbursement for these 
services 
if 
the 
services 
are 
performed 
by 
a 
physician; 
a 
psychologist licensed to practice in this State; 
a 
certified 
social worker licensed for the independent practice of social 
work 
wRe--ha-s--a~-~~--a-ma£~~~-~~-~£-~~~-we£~-~~~-aB 
aee~eai~ea-~Hea~ieaa±--~~~~~r-~--ha-s--~~£--effi~Jeyea--iB 
seeia±-we£~-~e£-~-~~~~~r~~r-a~~~-&aaHaFy-lr-±9g9r 
ffi~s~-~-~ie&a&ee-~--a-€JJRJ€aJ-~~~-we~*eF in this State; a 
licensed 
clinical 
professional 
counselor 
licensed 
for 
the 
independent practice of counseling 
wRe--h-af;...-a-t--1-B-a&t--~-ffias~e~s 
ae~~ee-~~~~~-~Fem-aR-~~~~~t-~&&~-iBS~i~~~ieBT 
Ras-~~~-~~-ia-ee~Bse±iB~-~~-~-~ea&~-~-~~-aaGr-aE~e~ 
JaB~a~Y--~r-~~~--ffi~S~-~-~~~-as--a-~~~~~~--~~eEessieBa± 
ee~Bse±e~ in this State; a licensed pastoral counselor licensed 
as 
a 
pastoral 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. 
Payment or reimbursement for 
services 
rendered by clinical social workers 
licensed 
In this State, 
licensed clinical professional counselors licensed in this State L 
licensed pastoral 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 
Page l-LR0269(1) 
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 I may be construed to require a 
health insurance policy subject to this chapter to provide for 
reimbursement of services 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 to practice in this State, 
£ 
licensed pastoral counselor licensed in this State, a certified 
social worker licensed to practice in this State, or a certified 
nurse licensed to practice in this State. 
3. 
Mental 
health 
services 
provided 
by 
counseling 
professionals. 
Except as provided in subsection 1 with regard to 
reimbursement of clinical professional counselors and pastoral 
counselors 
licensed 
in 
this 
State, 
an 
insurer 
that 
issues 
indi vidual health care contracts providing coverage for mental 
health services shall offer coverage for 
those services when 
performed by a counseling professional who is licensed by the 
State pursuant to Title 32, 
chapter 119 to assess and treat 
interpersonal and intrapersonal problems, has at least a masters 
degree 
in counseling or 
a 
related field 
from 
an accredited 
educational institution and has been employed as a counselor for 
at least 
years. 
Any 
contract providing coverage 
for 
the 
services of counseling professionals pursuant to this section may 
be 
subject 
to 
any 
reasonable 
limitations, 
maximum 
benefits, 
coinsurance, deductibles or exclusion provisions applicable to 
overall benefits under the contract. This subsection applies to 
all contracts executed, delivered, issued for delivery, continued 
or 
renewed in this State on or after January 1, 
1997. 
For 
purposes of this subsection, all contracts are deemed renewed no 
later than the next yearly anniversary of the contract date. 
Sec. 2. 24-A MRSA §2835, as amended by PL 2003, c. 517, Pt. 
B, §13, is further amended to read: 
§2835. Mental health services 
1. 
Notwithstanding 
any 
provision of 
a 
health insurance 
policy or certificate issued under a group policy subject to this 
chapter, 
whenever 
the 
policy 
provides 
for 
payment 
or 
reimbursement for services that are within the lawful scope of 
practice of a psychologist licensed to practice in this State: a 
certified social worker licensed for the independent practice of 
social work in this State wae-has--a-t--Mast:--a--ma&t-€-C-G--Geq-F-e-&--iR 
6geia*-w0£k-~~~~&-aeeF9aitea-eQ~~~4eBa~-~~~~~~~-~-geeR 
emp*9yea-~-6eeia*-~~-~9£-~-~~~--b-~~--aBQ-~--aiteF 
JaBQaFY-~7-~~-~-~-1ieeBsee-as-~-~~~~~-~~~-W&~~~-iR 
t.Ris-.s~at.e; a licensed clinical professional counselor licensed 
for the independent practice' of counseling wRe--has--at.--J.-eas-t--a 
mast.eFs--ee~Fee--iB--eeQBSeliB~--~Fem--aB--aeeFeeit.ea--eaQeat.ieBal 
iBSt.it.Qt.ieBT-Ras-&eeB-~~~~~~l~~~~~-~~s~-b-yeaFs 
aBaT--~~~~-~1r-~~--~QQ~7--mQst.--&e--~~-~-~--eliBieal 
pFe~essiea~1--eeQBSeleF 
in 
this 
State; 
a 
licensed 
pastoral 
counselor licensed as a pastoral 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 is entitled to reimbursement for these 
services 
if the 
services 
are 
performed 
by 
a 
physician; 
a 
psychologist licensed to practice in this State; 
a 
certified 
social worker licensed for independent practice in this State wae 
aas-~~-~--a-mast.eF6-~~-~-seeia1-weFk-~~~~&-aeeFeait.ee 
eaQeat.ieBal-4B6~4~H~4eR7-w£~~~~~-~-~i~~-weF*-~eF 
at.--~~s~-~--ye-ar-fh--~£tl--waeT--aH:eF---J.an.u.a-:r;:.y---±-,--~~--mH6~--ee 
lieeBsea-~~-el4B4€al-~~~-weF*eF-~£-~~~-~t.a~e; a licensed 
clinical 
professional 
counselor 
licensed 
for 
the 
independent 
practice of counseling 
wRe--has---at--lea6~--a--ma&t.-4H"-6--tl~.ee--iR 
eeQBseliB~-~~~-aa-~~~~~~~~~~-4R6~4~H~ieR7--has--eeeR 
empleyea-4R-eeHB6e~~B~-~~-~--J.~~-~r&~a4r-a~~F-JaBQaFy-lT 
~GG~T-~--ee--J.~~-as-~-e1iaiea1-~~~~--eeQBSeleF in 
this State; a licensed pastoral counselor licensed as a pastoral 
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. 
Payment or reimbursement for services rendered by clinical social 
workers licensed in this State, licensed clinical professional 
counselors licensed in this State, licensed pastoral 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 require a 
heal th insurance policy subject to this chapter to provide for 
reimbursement of services that are wi thin 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 
licensed 
pastoral 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. 
3. 
Mental 
health 
services 
provided 
by 
counseling 
professionals. 
Except as provided in subsection 1 with regard to 
reimbursement of clinical professional counselors and pastoral 
counselors licensed in this State, an insurer that issues group 
health 
care 
contracts 
providing 
coverage 
for 
mental 
health 
services shall make available coverage for those services when 
performed by a counseling professional who is licensed by the 
State pursuant to Title 32, 
chapter 119 to assess and treat 
interpersonal and intrapersonal problems, has at least a masters 
degree 
in counseling or 
a 
related field 
from 
an accredited 
educational institution and has been employed as a counselor for 
at least 
years. 
Any 
contract providing coverage 
for 
the 
services of counseling professionals pursuant to this section may 
be 
subject 
to 
any 
reasonable 
limitations, 
maximum 
benefits, 
coinsurance, deductibles or exclusion provisions applicable. to 
overall benefits under the contract. 
This subsection applies to 
all policies, 
contracts 
and certificates executed, 
delivered, 
issued for delivery, continued or renewed in this State. 
For 
purposes of this subsection, all contracts are deemed renewed no 
later than the next yearly anniversary of the contract date. 
Sec. 3. 
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, 2006. 
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 requires that all health care plans reimburse for 
mental health services provided by licensed pastoral counselors 
licensed in this State. 
The bill applies to all policies issued 
or renewed on or after January 1, 2006.