Maine LD 636: An Act To Provide Consumers of Health Care with Information Regarding Health Care Costs

LD 636 (subjects: INSURANCE PRACTICES , DISCLOSURE )

Official bill page at mainelegislature.org: http://www.mainelegislature.org/legis/bills/display_ps.asp?ld=636&PID=1456&snum=127


Sponsors | Actions | Bill Text & Amendments | Patterns of Support


Sponsors

Principal Sponsor: Sen. James Dill of Penobscot: (D – District 5) — e-mail

5 Cosponsors:

Actions

Chamber

Action
3/3/2015 Senate Committee on INSURANCE AND FINANCIAL SERVICES
suggested and ordered printed
On motion by Senator Whittemore of Somerset REFERRED to the Committee on INSURANCE AND FINANCIAL SERVICES
Ordered sent down forthwith for concurrence.
3/3/2015 House Bill REFERRED to the Committee on INSURANCE AND FINANCIAL SERVICES.
In concurrence. ORDERED SENT FORTHWITH.
5/12/2015 Senate Report READ and ACCEPTED.
READ ONCE.

Committee Amendment “A” (S-74) READ and ADOPTED.

Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED BY Committee Amendment “A” (S-74) .

Ordered sent down forthwith for concurrence.
5/13/2015 House CONSENT CALENDAR – FIRST DAY
Under suspension of the rules
CONSENT CALENDAR – SECOND DAY.
The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment “A” (S-74).
In concurrence. ORDERED SENT FORTHWITH.
5/19/2015 House PASSED TO BE ENACTED.
Sent for concurrence. ORDERED SENT FORTHWITH.
5/20/2015 Senate On motion by Senator MASON of Androscoggin Tabled until Later in Today’s Session, pending ENACTMENT , in concurrence.
Unfinished Business
5/21/2015 Senate Unfinished Business
5/26/2015 Senate Unfinished Business
5/27/2015 Senate Unfinished Business
5/28/2015 Senate Unfinished Business
5/29/2015 Senate Unfinished Business
6/1/2015 Senate Unfinished Business
6/2/2015 Senate Unfinished Business
6/3/2015 Senate Unfinished Business
6/4/2015 Senate Unfinished Business
6/5/2015 Senate Unfinished Business
6/8/2015 Senate Unfinished Business
6/9/2015 Senate Unfinished Business
6/10/2015 Senate Taken from the table by the President ProTem
PASSED TO BE ENACTED , in concurrence.
6/23/2015 Senate LD 636 In Senate, June 23, 2015, this Bill, having been returned by the Governor, together with objections to the same pursuant to the provisions of the Constitution of the State of Maine, after reconsideration, the Senate proceeded to vote on the question: “Shall this Bill become a law notwithstanding the objections of the Governor?” 31 In Favor and 3 Against , accordingly it was the vote of the Senate that the Bill become law and the VETO was OVERRIDDEN.
Ordered sent down forthwith for concurrence.
6/23/2015 House This Bill, having been returned by the Governor, together with objections to the same pursuant to Article IV, Part Third, Section 2 of the Constitution of the State of Maine, after reconsideration, the House proceeded to vote on the question: “Shall this Bill become a law notwithstanding the objections of the Governor?”
ROLL CALL NO. 382V
126 having voted in the affirmative and 12 in the negative, with 13 being absent, and accordingly it was the vote of the House that the Bill become a law notwithstanding the objections of the Governor, since two-thirds of the members of the House so voted.
In concurrence. ORDERED SENT FORTHWITH.

Bill Text & Amendments

Important Note: The bill text below presents L.D. 636 as originally introduced. L.D. 636 was changed by the legislature through amendment. To understand the impact of this legislation in proper context, be sure to read adopted amendment text, available here: C-A (S-74) .

An Act To Provide Consumers of Health Care with Information Regarding Health Care Costs

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 24-A MRSA 4303, sub- 20 is enacted to read:

20. Information about prescription drugs. A carrier offering a health plan in this State shall provide the following information to prospective enrollees and enrollees with respect to prescription drug coverage on its publicly accessible website.

A. A carrier shall post each prescription drug formulary for each health plan offered by the carrier. The prescription drug formularies must be posted in a manner that allows prospective enrollees and enrollees to search the formularies and compare formularies to determine whether a particular prescription drug is covered under a formulary. When a change is made to a formulary, the updated formulary must be posted on the website within 72 hours.
B. A carrier shall provide an explanation of:

(1) The requirements for utilization review, prior authorization or step therapy for each category of prescription drug covered under a health plan;

(2) The cost-sharing requirements for prescription drug coverage, including a description of how the costs of prescription drugs will specifically be applied or not applied to any deductible or out-of-pocket maximum required under a health plan;

(3) The exclusions from coverage under a health plan and any restrictions on use or quantity of covered health care services in each category of benefits; and

(4) The amount of coverage provided under a health plan for out-of-network providers or noncovered health care services and any right of appeal available to an enrollee when out-of-network providers or noncovered health care services are medically necessary.

summary

This bill requires all health insurance carriers offering individual and group health plans to provide certain information with respect to prescription drug coverage to prospective enrollees and enrollees on its publicly accessible website. The bill requires carriers to post each prescription drug formulary for each health plan in a manner that allows enrollees to determine whether a particular prescription drug is covered under a formulary. The bill also requires carriers to provide information about utilization review, prior authorization or step therapy, cost-sharing, exclusions from coverage and the amount of coverage for out-of-network providers or noncovered health care services.

Patterns of Support

Pattern of Cosponsorship by Region:

Pattern of Cosponsorship by Gender:

Pattern of Cosponsorship by Party:

Pattern of Cosponsorship by Campaign Finance Classification:

Note: Maine Clean Elections Act (MCEA) Qualified candidates only accept a small dollar value of initial contributions early in their campaigns, pledge not to accept further campaign contributions from private sources, and receive public funding for their campaigns. MCEA Non-Qualified candidates choose not to obtain public funding and instead are free to accept campaign contributions from individuals, party committees, political action committees and business sources.


This information about LD 636 was last updated on 2016-05-12.
The Open Maine Politics website is in a beta release and results should not be taken as definitive. Please visit the official website of the Maine State Legislature for entirely verifiable information.

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