An Act to Improve Parity in Insurance Coverage for Outpatient
Maine Legislature, Session 132, LD 1589
Committee: Health Coverage, Insurance and Financial Services
Sponsors: CRAFTS
Amends: 24-A MRSA §2744, 24-A MRSA §2835, 24-A MRSA §4234-A

Legislative Document
No. 1589
H.P. 1047
House of Representatives, April 10, 2025
An Act to Improve Parity in Insurance Coverage for Outpatient 
Counseling Services in Maine
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative CRAFTS of Newcastle.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §2744, sub-§2, as repealed and replaced by PL 2005, c. 683, 
Pt. A, §39, is repealed.
Sec. 2.  24-A MRSA §2744, sub-§2-A, as repealed and replaced by PL 2005, c. 
683, Pt. A, §39, is amended to read:
2-A.   Subsections 1 and 2 apply Subsection 1 applies with respect to the following 
types of professionals:
A.  A psychologist licensed to practice in this State;
B.  A certified social worker licensed for the independent practice of social work in 
this State;
C.  A licensed clinical professional counselor licensed for the independent practice of 
counseling in this State;
D.  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;
E.  A marriage and family therapist licensed as a marriage and family therapist in this 
State; and
F.  A licensed pastoral counselor licensed as a pastoral counselor in this State.
Sec. 3.  24-A MRSA §2744, sub-§3, as repealed and replaced by PL 2005, c. 683, 
Pt. A, §39, is repealed.
Sec. 4.  24-A MRSA §2744, sub-§4 is enacted to read:
4.  Coverage of outpatient counseling services; reimbursement and participation.  
An insurer that issues individual health care contracts providing coverage for mental health 
services shall provide coverage for outpatient counseling services in accordance with this 
subsection. 
A. An insurer shall reimburse for outpatient counseling services when those services 
are provided by a licensed counseling professional providing services that are within 
the lawful scope of practice of the counseling professional’s license, including a master 
social worker, clinical social worker, clinical professional counselor, pastoral 
counselor or marriage and family therapist. 
B. At a minimum, an insurer shall reimburse for outpatient counseling services in an 
amount equal to 150% of the MaineCare reimbursement rate for that service. 
C. An insurer may not discriminate against a licensed counseling professional as 
described in paragraph A or arbitrarily reduce the reimbursement rate for outpatient 
counseling services provided by a licensed counseling professional based solely on the 
type of license held by a licensed counseling professional. 
D. An insurer may not impose prior authorization or referral requirements as a 
condition of coverage for outpatient counseling services or impose any restriction or 
limitation on access to outpatient counseling services that does not have a clinical basis. 
E. An insurer shall maintain an adequate network of licensed counseling professionals 
to ensure reasonable access to outpatient counseling services.
Sec. 5.  24-A MRSA §2835, sub-§2, as repealed and replaced by PL 2005, c. 683, 
Pt. A, §40, is repealed.
Sec. 6.  24-A MRSA §2835, sub-§2-A, as repealed and replaced by PL 2005, c. 
683, Pt. A, §40, is amended to read:
2-A.   Subsections 1 and 2 apply Subsection 1 applies with respect to the following 
types of professionals:
A.  A psychologist licensed to practice in this State;
B.  A certified social worker licensed for the independent practice of social work in 
this State;
C.  A licensed clinical professional counselor licensed for the independent practice of 
counseling in this State;
D.  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;
E.  A marriage and family therapist licensed as a marriage and family therapist in this 
State; and
F.  A licensed pastoral counselor licensed as a pastoral counselor in this State.
Sec. 7.  24-A MRSA §2835, sub-§3, as repealed and replaced by PL 2005, c. 683, 
Pt. A, §40, is repealed.
Sec. 8.  24-A MRSA §2835, sub-§4 is enacted to read:
4.  Coverage of outpatient counseling services; reimbursement and participation.  
An insurer that issues group health care contracts providing coverage for mental health 
services shall provide coverage for outpatient counseling services in accordance with this 
subsection. 
A. An insurer shall reimburse for outpatient counseling services when those services 
are provided by a licensed counseling professional providing services that are within 
the lawful scope of practice of the counseling professional’s license, including a master 
social worker, clinical social worker, clinical professional counselor, pastoral 
counselor or marriage and family therapist. 
B. At a minimum, an insurer shall reimburse for outpatient counseling services in an 
amount equal to 150% of the MaineCare reimbursement rate for that service. 
C. An insurer may not discriminate against a licensed counseling professional as 
described in paragraph A or arbitrarily reduce the reimbursement rate for outpatient 
counseling services provided by a licensed counseling professional based solely on the 
type of license held by a licensed counseling professional. 
D. An insurer may not impose prior authorization or referral requirements as a 
condition of coverage for outpatient counseling services or impose any restriction or 
limitation on access to outpatient counseling services that does not have a clinical basis. 
E. An insurer shall maintain an adequate network of licensed counseling professionals 
to ensure reasonable access to outpatient counseling services.
Sec. 9.  24-A MRSA §4234-A, sub-§8-A, as amended by PL 2003, c. 20, Pt. VV, 
§23 and affected by §25, is repealed.
Sec. 10.  24-A MRSA §4234-A, sub-§8-B is enacted to read:
8-B.  Coverage of outpatient counseling services; reimbursement and 
participation.  A health maintenance organization that issues individual or group health 
care contracts providing coverage for mental health services shall provide coverage for 
outpatient counseling services in accordance with this subsection. 
A. A health maintenance organization shall reimburse for outpatient counseling 
services when those services are provided by a licensed counseling professional 
providing services that are within the lawful scope of practice of the counseling 
professional’s license, including a master social worker, clinical social worker, clinical 
professional counselor, pastoral counselor or marriage and family therapist. 
B. At a minimum, a health maintenance organization shall reimburse for outpatient 
counseling services in an amount equal to 150% of the MaineCare reimbursement rate 
for that service. 
C. A health maintenance organization may not discriminate against a licensed 
counseling professional as described in paragraph A or arbitrarily reduce the 
reimbursement rate for outpatient counseling services provided by a licensed 
counseling professional based solely on the type of license held by a licensed 
counseling professional. 
D. A health maintenance organization may not impose prior authorization or referral 
requirements as a condition of coverage for outpatient counseling services or impose 
any restriction or limitation on access to outpatient counseling services that does not 
have a clinical basis. 
E. A health maintenance organization shall maintain an adequate network of licensed 
counseling professionals to ensure reasonable access to outpatient counseling services.
Sec. 11.  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, 2026. 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 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 
licensed counseling professional. The bill prohibits the imposition of prior authorization or 
referral requirements as a condition of coverage for outpatient counseling services or the 
imposition of any restriction or limitation on access to outpatient counseling services that 
does not have a clinical basis. The bill also requires that insurers and health maintenance 
organizations maintain an adequate network of licensed counseling professionals to ensure 
reasonable access to outpatient counseling services. The requirements apply beginning 
January 1, 2026.