An Act To Ensure Continued Coverage for Essential Health Care
Sec. 1. 24-A MRSA §4320-A, as enacted by PL 2011, c. 364, §34, is amended to read:
§ 4320-A. Coverage of preventive health services
Notwithstanding any other requirements of this Title, a carrier offering a health plan subject to the federal Affordable Care Act in this State shall, at a minimum, provide coverage for and may not impose cost-sharing requirements for preventive services as required by the federal Affordable Care Act this section.
(1) Well-woman preventive care;
(2) Contraception in accordance with subsection 2;
(3) Screening for breast cancer;
(4) Screening for cervical cancer;
(5) Screening for HIV;
(6) Screening for gestational diabetes;
(7) Folic acid supplementation;
(8) Breastfeeding services and supplies;
(9) Screening for interpersonal and domestic violence;
(10) Counseling for sexually transmitted infections;
(11) Breast cancer chemoprevention counseling; and
(12) Risk assessment for a BRCA gene mutation and genetic counseling or testing if necessary.
A health plan may not impose any restrictions or delays on the coverage of contraceptive methods and services required under this subsection.
Sec. 2. Application. The requirements of this Act apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2018. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.
This bill incorporates current requirements under the federal Patient Protection and Affordable Care Act for coverage of preventive health services, including services for women, into state law. The bill also requires coverage of certain contraceptive methods and services. The bill directs the Superintendent of Insurance to annually review the recommendations and guidelines for coverage of preventive health services to identify any gaps in the minimum coverage provided by health plans and authorizes the joint standing committee of the Legislature having jurisdiction over health insurance matters to introduce legislation to update the requirements for minimum coverage. The requirements apply to all individual and group health insurance policies and contracts issued or renewed on or after January 1, 2018.