§1066. Universal Immunization Program
(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)
(WHOLE SECTION TEXT EFFECTIVE 7/01/26)
1.
Program established.
The Universal Immunization Program is established to provide all individuals in the State with access to a uniform set of vaccines as determined and periodically updated by the Maine Vaccine Board. The program is administered by the department for the purposes of expanding access to immunizations against all diseases as recommended by the federal Department of Health and Human Services, Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, optimizing public and private resources and lowering the cost of providing immunizations to individuals in the State. The program is overseen by the Maine Vaccine Board.
[PL 2025, c. 440, §2 (AMD); PL 2025, c. 440, §17 (AFF).]
2.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A.
"Advisory committee" means the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services, Centers for Disease Control and Prevention or its successor organization.
[PL 2009, c. 595, §2 (NEW).]
A-1.
"AAF" means an assessment adjustment factor to adjust for variations between health insurance carriers to maintain equity in assessment allocations among assessed entities.
[PL 2025, c. 440, §3 (NEW); PL 2025, c. 440, §17 (AFF).]
B.
"Assessed entity" means a health insurance carrier or a 3rd-party administrator registered under Title 24‑A.
[PL 2009, c. 652, Pt. E, §1 (AMD); PL 2009, c. 652, Pt. E, §3 (AFF).]
D.
[PL 2025, c. 440, §4 (RP); PL 2025, c. 440, §17 (AFF).]
E.
"Covered life months" means the number of months during a calendar year that a person is covered under a health insurance plan provided or administered by an assessed entity.
[PL 2009, c. 652, Pt. E, §2 (AMD); PL 2009, c. 652, Pt. E, §3 (AFF).]
F.
"Fund" means the Immunization Fund established in subsection 7.
[PL 2025, c. 440, §5 (AMD); PL 2025, c. 440, §17 (AFF).]
G.
"Health insurance carrier" means:
(1)
An insurance company licensed in accordance with Title 24‑A to provide health insurance;
(2)
A health maintenance organization licensed pursuant to Title 24‑A, chapter 56;
(3)
A preferred provider arrangement administrator registered pursuant to Title 24‑A, chapter 32;
(4)
A fraternal benefit society as defined in Title 24‑A, section 4101;
(5)
A nonprofit hospital or medical service organization or health plan licensed pursuant to Title 24;
(6)
A multiple-employer welfare arrangement approved by the superintendent under Title 24‑A, section 6603; or
(7)
A self-insured employer subject to state regulation as described in Title 24‑A, section 2848‑A.
[PL 2009, c. 595, §2 (NEW).]
G-1.
"Individual" means a person who resides in the State.
[PL 2025, c. 440, §6 (NEW); PL 2025, c. 440, §17 (AFF).]
H.
"New vaccine" means a vaccine recommended by the advisory committee for which an initial federal contract price is established by the United States Department of Health and Human Services, Centers for Disease Control and Prevention between October 1st and July 1st.
[PL 2009, c. 595, §2 (NEW).]
I.
"Program" means the Universal Immunization Program established in subsection 1.
[PL 2025, c. 440, §7 (AMD); PL 2025, c. 440, §17 (AFF).]
J.
"Provider" means a person licensed by this State to provide health care services to individuals or a partnership or corporation made up of those persons.
[PL 2009, c. 595, §2 (NEW).]
K.
"Service agent" means a person or entity qualified by good business reputation, training, education and experience to administer the fund and perform responsibilities assigned by the board. A service agent must hold all licenses, registrations and permits required to engage in activities or undertake responsibilities assigned by the board.
[PL 2009, c. 595, §2 (NEW).]
L.
"Superintendent" means the Superintendent of Insurance.
[PL 2009, c. 595, §2 (NEW).]
M.
"Total costs of the fund" means the costs of vaccines provided under the program to individuals projected to be covered by assessed entities during the succeeding program year and the annual operating expenses of the board, including costs the board may incur for staff, a service agent, legal representation, administrative support services and other expenses approved by the board.
[PL 2025, c. 440, §8 (AMD); PL 2025, c. 440, §17 (AFF).]
[PL 2025, c. 440, §§3-8 (AMD); PL 2025, c. 440, §17 (AFF).]
3.
Maine Vaccine Board.
The Maine Vaccine Board is established pursuant to this subsection to oversee the program.
A.
The board consists of 9 members.
(1)
The commissioner shall serve as an ex officio, nonvoting member.
(3)
The Governor shall appoint 8 members, as follows:
(a)
Three representatives of health insurance carriers, appointed from a list of nominees submitted by a statewide association of health insurance carriers;
(b)
Three representatives of providers in the State, appointed from lists of nominees submitted by statewide associations of providers, including associations of primary care providers, allopathic and osteopathic physicians, nurse practitioners and persons with expertise in public health;
(c)
A representative of employers that self-insure for health coverage, appointed from lists of nominees submitted by statewide associations of employers; and
(d)
A representative of the pharmaceutical manufacturing industry, appointed from a list of nominees submitted by a statewide association of pharmaceutical manufacturers.
[PL 2017, c. 7, §1 (AMD).]
B.
The term of an appointed member to the board is 3 years. All members, with the exception of the representative of the pharmaceutical manufacturing industry, may serve successive terms. A member whose term has expired may serve until the appointment of the member's successor.
[PL 2025, c. 440, §9 (AMD); PL 2025, c. 440, §17 (AFF).]
C.
The board shall elect a chair from among its members to serve a 2-year term or for the duration of that person's term. The chair may serve successive terms. Five voting members constitute a quorum. Decisions of the board require the affirmative vote of 5 members.
[PL 2009, c. 595, §2 (NEW).]
D.
The board shall meet not fewer than 2 times per year and when a meeting is called by the chair and shall oversee the fund and program and adopt policies and procedures to administer the program and the fund.
[PL 2025, c. 440, §10 (AMD); PL 2025, c. 440, §17 (AFF).]
E.
By January 1, 2011 and annually thereafter, the board shall determine the list of vaccines to be made available by the program during the succeeding program year beginning July 1st. In making its determination, the board shall consider:
(1)
Vaccines that are available under contract with the United States Department of Health and Human Services, Centers for Disease Control and Prevention, by direct manufacturer purchase, through the Minnesota Multistate Contracting Alliance for Pharmacy or a successor organization or by any other low-cost bulk purchase option;
(2)
Recommendations of the department; and
(3)
Clinical and cost-benefit analyses.
The board shall review new vaccines and update the list of vaccines to be made available through the program on a timely basis in accordance with the considerations described in this paragraph.
[PL 2025, c. 440, §11 (AMD); PL 2025, c. 440, §17 (AFF).]
F.
The board shall contract for staff, administrative support services and, if necessary, legal representation; review financial, cost and other information about the program annually or more often as determined by the chair; and pay the costs of the service agent under subsection 9, legal representation and contracted services from the fund.
[PL 2009, c. 595, §2 (NEW).]
[PL 2025, c. 440, §§9-11 (AMD); PL 2025, c. 440, §17 (AFF).]
4.
Program requirements.
The program shall make available to providers vaccines as determined by the board pursuant to subsection 3, paragraph E.
[PL 2009, c. 595, §2 (NEW).]
5.
Assessments.
By January 1, 2011 and annually thereafter, the board shall determine one or more assessments for each assessed entity in accordance with this subsection. The board shall provide a mechanism to protect against duplicate counting of individuals. The board may conduct an audit of the number of covered life months for individuals as reported by an assessed entity. An assessment determination made pursuant to this subsection is an adjudicatory proceeding within the meaning of Title 5, chapter 375, subchapter 4.
A.
In determining the amount of the assessment, the board shall, as it determines appropriate following a public hearing, establish one or more subfunds by age and coverage type and, for each subfund:
(1)
Determine the total costs of the subfund for the succeeding program year;
(2)
Add a reserve of up to 10% of the total costs of the subfund under subparagraph (1) for unanticipated costs associated with providing vaccines to individuals covered by the assessed entity;
(2-A)
Add an administrative allowance for the department of up to 10% of the total costs of the subfund;
(3)
Subtract the amount of any unexpended assessments collected in the preceding year and any unexpended interest accrued to the subfund during the preceding year; and
(4)
Calculate the assessment on a monthly basis per individual to be paid by an assessed entity by dividing the amount determined in accordance with subparagraphs (1), (2), (2-A) and (3) by the number of individuals projected to be covered by the assessed entity during the succeeding program year divided by 12.
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
B.
The board shall provide the assessed entity with notice of the assessment amount for each subfund established pursuant to paragraph A for the succeeding program year no later than January 1, 2011 and annually thereafter.
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
C.
Beginning July 1, 2025, the assessment must be paid on a quarterly basis as follows:
(1)
An assessed entity shall pay a quarterly assessment for each subfund established pursuant to paragraph A equal to the monthly assessment rate per individual as described under paragraph A, subparagraph (4) multiplied by the number of individual member months covered by the assessed entity in the preceding calendar quarter; and
(2)
The assessment must be paid within 45 days following the close of the calendar quarter.
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
D.
After the close of a program year, the board shall reconcile the total assessments paid by assessed entities, including interim assessments determined under paragraph E, with the actual costs of vaccines provided under the program to individuals covered by assessed entities during that program year and the annual operating expenses of the program during that program year. Any unexpended assessments must be used to reduce the assessment for the respective subfund established pursuant to paragraph A in the succeeding program year as required under paragraph A, subparagraph (3).
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
E.
The board may determine an interim assessment for new vaccines that the board has made available through the program pursuant to subsection 3, paragraph E. The board shall calculate the interim assessment in accordance with paragraph A, and the interim assessment is payable the calendar quarter that begins no less than 30 days following the establishment of the federal contract price. The board may not impose more than one interim assessment per year, except in the case of a public health emergency declared in accordance with state or federal law.
[PL 2009, c. 595, §2 (NEW).]
F.
If the combination of funding available from the United States Department of Health and Human Services, Centers for Disease Control and Prevention, Vaccines for Children Program and the immunization grant program under the federal Public Health Service Act, Section 1928 of the Social Security Act, 42 United States Code, Section 1396s is insufficient to provide coverage for vaccines for the children who qualify for vaccines under the Vaccines for Children Program, money from the fund may not be used to cover the cost of vaccines for children who would otherwise be provided vaccines under the Vaccines for Children Program.
[PL 2009, c. 595, §2 (NEW).]
G.
If the assessments under this subsection are insufficient to cover the cost of vaccines to be provided to individuals covered by assessed entities, the State is not required to cover the cost of vaccines for those individuals.
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
H.
For any subfund established pursuant to paragraph A after June 2025, after one year of operation and until discontinued by a 2/3 vote of the board determining that the adjustments described in this paragraph are not needed to maintain equity in assessment allocations among assessed entities, the following apply:
[PL 2025, c. 440, §12 (AMD); PL 2025, c. 440, §17 (AFF).]
(1)
Annually, assessed entities shall supply such data as may be determined by the board to be necessary for the purposes of this subsection and reasonably convenient for the assessed entities to supply in order to enable the calculations of the AAF for each entity, to multiply by the otherwise applicable assessment amount to adjust for variations between entities in the split between participating and nonparticipating providers in vaccine costs of that entity's covered individuals. The service agent shall compute the AAF annually for each entity based on supplied data;
(2)
Annually, AAF calculations must be completed during the first quarter of each calendar year; and
(3)
Each assessment amount otherwise calculated in accordance with this subsection must be multiplied by the AAF for the respective entity to compute the final assessment due.
[PL 2025, c. 440, §12 (NEW); PL 2025, c. 440, §17 (AFF).]
6.
Failure to pay assessment.
If an assessment under subsection 5 is not paid on the due date established by the board, the provisions of this subsection apply.
A.
The board shall submit a report to the superintendent listing each assessed entity that has failed to pay an assessment under subsection 5.
[PL 2009, c. 595, §2 (NEW).]
B.
If an assessed entity has not paid an assessment under subsection 5 within 45 days following the close of the calendar quarter, interest accrues at 12% per annum on or after the due date. Interest paid under this paragraph must be deposited into the fund. Upon application, the board may waive such interest payments for good cause shown.
[PL 2009, c. 595, §2 (NEW).]
The superintendent may take any action authorized under Title 24‑A to enforce collection of any unpaid assessment or fine and may impose any penalty authorized under Title 24‑A for noncompliance with this section if the assessed entity has engaged in a pattern of conduct that demonstrates a lack of good faith in complying with the requirements of this subsection.
[PL 2009, c. 595, §2 (NEW).]
7.
Fund.
The Immunization Fund is established for the sole purpose of funding the program, including any costs of vaccines provided under the program to individuals and any costs the board may incur for staff, a service agent, administrative support services, legal representation and contracted services. The fund is administered by the board or the service agent, which shall act as a fiduciary and manage and invest the fund in conformance with prudent investor standards and maintain complete records of all assets, investments, deposits, disbursements and other transactions of the fund. All money and securities in the fund must be held in trust by the Treasurer of State for the purpose of making payments under this section and are not money or property for the general use of the State. The Treasurer of State is the custodian of the fund and may make disbursements only upon written direction from the board or the service agent. All assessments collected pursuant to this section, all interest on the balance in the fund and all income from any other source must be deposited into the fund. The fund does not lapse. No portion of the fund may be used to subsidize other programs or budgets.
[PL 2025, c. 440, §13 (AMD); PL 2025, c. 440, §17 (AFF).]
8.
Reporting.
By January 15th of each year, the board shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters regarding the operation of the program, the progress of the program in expanding access to immunizations for individuals and the assets, investments and expenditures of the fund.
[PL 2025, c. 440, §14 (AMD); PL 2025, c. 440, §17 (AFF).]
9.
Service agent.
The board, by written contract, may delegate administration of the fund to a service agent. The service agent:
A.
May contract with attorneys acceptable to the board for legal representation for the board;
[PL 2009, c. 595, §2 (NEW).]
B.
May levy assessments, institute collection procedures, including legal action if necessary, and deposit money in the fund with the Treasurer of State if those funds are not needed to meet immediate cash flow demands; and
[PL 2009, c. 595, §2 (NEW).]
C.
Shall make recommendations to the board regarding policies, rules and standards necessary for the proper administration of the fund.
[PL 2009, c. 595, §2 (NEW).]
[PL 2009, c. 595, §2 (NEW).]
10.
Freedom from liability.
There is no liability on the part of, and a cause of action may not arise against, a member of the board for any acts or omissions in the performance of the member's duties under this section. This immunity does not extend to willful neglect or malfeasance that would otherwise be actionable.
[PL 2009, c. 595, §2 (NEW).]
11.
Rules.
The department and the board shall jointly adopt rules to implement this section. Rules adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 375, subchapter 2‑A.
[PL 2009, c. 595, §2 (NEW).]
SECTION HISTORY
PL 2009, c. 595, §2 (NEW). PL 2009, c. 652, Pt. E, §§1, 2 (AMD). PL 2009, c. 652, Pt. E, §3 (AFF). PL 2017, c. 7, §1 (AMD). PL 2025, c. 440, §§1-14 (AMD). PL 2025, c. 440, §17 (AFF).