Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 908-5 - Outpatient alcohol or other drug services(a) Minimal additional treatment as a covered benefit under this article shall be provided in a facility appropriately licensed by the Department of Health as an alcoholism or drug addiction treatment program. Before an insured may qualify to receive benefits under this section, a licensed physician or licensed psychologist must certify the insured as a person suffering from alcohol or other drug abuse or dependency and refer the insured for the appropriate treatment.(b) The following services shall be covered under this section: (1) Physician, psychologist, nurse, certified addictions counselor and trained staff services.(2) Rehabilitation therapy and counseling.(3) Family counseling and intervention.(4) Psychiatric, psychological and medical laboratory tests.(5) Drugs, medicines, equipment use and supplies.(c) Treatment under this section shall be covered as required by this act for a minimum of thirty outpatient, full-session visits or equivalent partial visits per year. Treatment may be subject to a lifetime limit, for any covered individual, of one hundred and twenty outpatient, full-session visits or equivalent partial visits.(d) In addition, treatment under this section shall be covered as required by this act for a minimum of thirty separate sessions of outpatient or partial hospitalization services per year, which may be exchanged on a two-to-one basis to secure up to fifteen additional non-hospital, residential alcohol treatment days.1921, May 17, P.L. 682, No. 284, § 605-A, added 1986, June 11, P.L. 226, No. 64, § 10, effective in 180 days. Amended 1989, Dec. 22, P.L. 755, No. 106, § 8, effective in 90 days.