An Act To Ensure Women's Health Care Coverage for All Maine Women
Maine Legislature, Session 121, LD 1353
Committee: Insurance and Financial Services
Sponsors: RICHARDSON, EDMONDS, BREAULT, CANAVAN, MARRACHE, O'NEIL, YOUNG, DOUGLASS, MITCHELL
Amends: 24 MRSA §2318, 24 MRSA §2318-A, 24 MRSA §2319, 24 MRSA §2320-C, 24 MRSA §2320-E, 24 MRSA §2332-J, 24-A MRSA §2741, 24-A MRSA §2743, 24-A MRSA §2743-A, 24-A MRSA §2834-A, 24-A MRSA §2837-C, 24-A MRSA §2837-E, 24-A MRSA §2847-F, 24-A MRSA §2847-G, 24-A MRSA §4234-B, 24-A MRSA §4247

Legislative Document 
No. 1353 
H.P.995 
House of Representatives, March 13, 2003 
An Act To Ensure Women's Health Care Coverage for All Maine 
Women 
(EMERGENCY) 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative RICHARDSON of Brunswick. 
Cosponsored by Senator EDMONDS of Cumberland and 
17/~ 
/J7.7l!tU~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BREAULT of Buxton, CANAVAN of Waterville, MARRACHE of 
Waterville, McNEIL of Rockland, O'NEIL of Saco, YOUNG of Limestone, Senators: 
DOUGLASS of Androscoggin, MITCHELL of Penobscot. 
Emergency preamble. Whereas, Acts of the Legislature do not 
become effective until 90 days after adjournment unless enacted 
as emergencies; and 
Whereas, 
this 
legislation 
affects 
all 
certificates 
of 
insurance executed, delivered, continued or renewed after July 1, 
2003; and 
Whereas, in the judgment of the Legislature, these facts 
create an emergency within the meaning of the Constitution of 
Maine 
and 
require 
the 
following 
legislation 
as 
immediately 
necessary for the preservation of the publ ic peace, heal th and 
safety; now, therefore, 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-I. 24 MRSA §2318, sub-§6 is enacted to read: 
6. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State after July 1, 2003. 
Sec. A-2. 24 MRSA §2318-A, as amended by PL 2001, c. 258, 
Pt. A, §l, is further amended to read: 
§2318-A. Maternity and routine newborn care 
A nonprofit hospital or medical service organization that 
issues 
individual 
and 
group 
contracts 
providing 
maternity 
benefits, 
including 
benefits 
for 
childbirth, 
shall 
provide 
coverage for services related to maternity and routine newborn 
care, including coverage for hospital stay, in accordance with 
the attending physician's or attending certified nurse midwife's 
determination in conjunction with the mother that the mother and 
newborn 
meet 
the 
criteria outlined 
in 
the 
"Guidelines 
for 
Perinatal Care," published by the American Academy of Pediatrics 
and the American College of Obstetrics and Gynecology. 
For the 
purposes of this section, "routine newborn care" does not include 
any services provided after the mother has been discharged from 
the hospital. 
For 
the purposes 
of this section, 
"attending 
physician" 
includes 
the 
obstetrician, 
pediatrician 
or 
other 
physician attending the mother and newborn. 
Benefits for routine 
newborn care required by this section are part of the mother's 
benefit. 
The mother and the newborn are treated as one person in 
calculating 
the 
deductible, 
coinsurance 
and 
copayments 
for 
coverage required by this section. 
In addition to policies and 
Page l-LR1577(1) 
contracts otherwise covered under this section, the requirements 
of this section apply to all certificates executed, delivered, 
issued for delivery, continued or renewed in this State after 
July 1, 2003. 
Sec. A-3. 24 MRSA §2319, last 1\, as amended by PL 1997, c. 604, 
Pt. C, §1, is further amended to read: 
The requirements of this section apply to all subscriber 
contracts delivered or issued for delivery in this State more 
than 120 days after 
t;be--e-f-f-e<H:-We--4a~e--G-~-~hl-s--Aet; April 1, 
1976. 
The requirements of this section additionally apply to all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. A-4. 24 MRSA §2320-C, sub-§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. A-5. 24 MRSA §2320-E, as enacted by PL 1995, c. 617, §l 
and affected by §6, is amended to read: 
§2320-E. Coverage for Pap tests 
All group nonprofit medical service plan contracts and all 
nonprofit health care plan contracts must provide coverage for 
screening Pap tests recommended by a physician. 
In addition to 
policies and contracts otherwise covered under this section, the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State after July 1, 2003. 
Sec. A-6. 24 MRSA §2332-J, sub-§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
PARTB 
Sec. B-1. 24-A MRSA §2741, as enacted by PL 1975, c. 276, §2, 
is amended to read: 
§274l. Maternity benefits for unmarried women policyholders and 
the minor dependents of policyholders with dependent or 
family coverage required 
All health insurance policies and plans saall must provide, 
at appropriate rates, the same maternity benefits for unmarried 
women policyholders and the minor dependents of policyholders 
with dependent or 
family coverage 
under 
the 
same 
terms 
and 
conditions as such maternity coverage is provided to married 
policyholders 
or 
the 
wives 
of 
policyholders 
with 
maternity 
coverage. This requirement saall-aFFly applies to all insurance 
policies and plans issued or renewed after Eae-~~~~~~~~-9E 
Eais--AeE January 1, 
1976. 
The 
requirements of this section 
additionally 
apply 
to 
all 
certificates 
executed, 
delivere~ 
issued for delivery, continued or renewed in this State after 
July 1, 2003. 
Sec. B-2. 24-A MRSA §2743, last 1[, as amended by PL 1997, c. 
604, Pt. C, §2, is further amended to read: 
The 
requirements of this section apply to all policies 
delivered or issued for delivery in this State more than 120 days 
after 
tae-~~~~~V&-~~-~--~h46--Aet April 
16, 
1976. 
The 
requirements 
of 
this 
section 
additionally 
apply 
to 
all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. B-3. 24-A MRSA §2743-A, as amended by PL 2001, c. 258, 
Pt. A, §2, is further amended to read: 
§2743-A. Maternity and routine newborn care 
An 
insurer 
that 
issues 
maternity benefits, 
including 
individual 
contracts 
providing 
benefits 
for 
childbirth, 
shall 
provide coverage for services related to maternity and routine 
newborn care, including coverage for hospital stay, in accordance 
with 
the 
attending physician's 
or 
attending certified nurse 
midwife's determination in conjunction with the mother that the 
mother and newborn meet the criteria outlined in the "Guidelines 
for 
Perinatal 
Care," 
published 
by 
the 
American 
Academy 
of 
Pediatrics 
and 
the 
American 
College 
of 
Obstetrics 
and 
Gynecology. 
For the purposes of this section, "routine newborn 
care" does not include any services provided after the mother has 
been discharged from the hospital. 
For the purposes of this 
section, 
"attending 
physician" 
includes 
the 
obstetrician, 
pediatrician 
or 
other 
physician 
attending 
the 
mother 
and 
newborn. 
Benefits for routine newborn care required by this 
section are part of the mother's benefit. 
The mother and the 
newborn are treated as one person in calculating the deductible, 
coinsurance 
and 
copayments 
for 
coverage 
required 
by 
this 
section. 
In addition to policies and contracts otherwise covered 
under this section, the requirements of this section apply to all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. B·4. 24·A MRSA §274S·C, sub·§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. B·S. 24·A MRSA §27S6, sub·§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
PARTC 
Sec. C·l, 24·A MRSA §2832, as amended by PL 1979, c. 663, 
§146, is further amended to read: 
§2832. Maternity benefits for unmarried women certificate holders 
and the minor dependents of certificate holders with 
dependent or family coverage required 
All group or blanket health insurance policies and plans 
sba~~ must provide the 
same maternity benefits for unmarried 
women 
certificate 
holders, 
and 
the 
minor 
dependents 
of 
certificate holders with dependent or family coverage, 
as is 
provided married certificate holders with maternity coverage and 
the wives of certificate holders with maternity coverage. This 
requirement sba~~-app~y applies to all group or blanket insurance 
written or renewed after ~be-€~~e€£4ve-~~~--~a~&-Ae~ January 
1, 1976, and sball--iR€-±l:iae includes, but is not be limited to, 
all types 
and 
forms 
of group insurance issued by individual 
companies or corporations. 
In addition to policies and contracts 
otherwise covered under this section, the requirements of this 
section apply to all certificates executed, delivered, issued for 
delivery, continued or renewed in this State after July 1, 2003. 
Sec. C·2. 24·A MRSA §2834, last 1r, as amended by PL 1997, c. 
604, Pt. C, §3, is further amended to read: 
The 
requirements 
of this section apply to all policies 
delivered or issued for delivery in this State more than 120 days 
after 
the--~~B&&~~¥&-~~-~--~hJ£--Aet April 
16, 
1976. 
The 
requirements 
of 
this 
section 
additionally 
apply 
to 
all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. C-3. 24-A MRSA §2834-A, as amended by PL 2001, c. 258, 
Pt. A, §3, is further amended to read: 
§2834-A. Maternity and routine newborn care 
An insurer that issues group contracts providing maternity 
benefits, 
including 
benefits 
for 
childbirth, 
shall 
provide 
coverage for services related to maternity and routine newborn 
care, including coverage for hospital stay, in accordance with 
the attending physician's or attending certified nurse midwife I s 
determination in conjunction with the mother that the mother and 
newborn 
meet 
the 
criteria outlined 
in 
the 
"Guidelines 
for 
Perinatal Care," published by the American Academy of Pediatrics 
and the American College of Obstetrics and Gynecology. 
For the 
purposes of this section, "routine newborn care" does not include 
any services provided after the mother has been discharged from 
the hospital. 
For 
the purposes of this section, 
"attending 
physician" 
includes 
the 
obstetrician, 
pediatrician 
or 
other 
physician attending the mother and newborn. 
Benefits for routine 
newborn care required by this section are part of the mother I s 
benefit. 
The mother and the newborn are treated as one person in 
calculating 
the 
deductible, 
coinsurance 
and 
copayments 
for 
coverage required by this section. 
In addition to policies and 
contracts otherwise covered under this section, the requirements 
of this section apply to all certificates executed, delivered, 
issued for delivery, continued or renewed in this State after 
July 1, 2003. 
Sec. C-4. 24-A MRSA §2837-C, sub-§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. C-S. 24-A MRSA §2837-E, as enacted by PL 1995, c. 617, 
§3 and affected by §6, is amended to read: 
§2837-E. Coveraqe for Pap tests 
All group health insurance policies 
accidental 
injury, 
specified 
disease, 
and contracts, except 
hospital 
indemnity, 
Medicare supplement, 
long-term care and other limited benefit 
heal th insurance policies and contracts, must provide coverage 
for screening Pap tests recommended by a physician. 
In addition 
to policies and contracts otherwise covered under this section, 
the 
requirements 
of 
this 
section 
apply 
to all certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State after July 1, 2003. 
Sec. C-6. 24-A MRSA §2847-F, sub-§2, as reallocated by PL 
1997, c. 370, Pt. H, §l, is amended to read: 
2. 
Application. 
This section applies to all policies and 
contracts executed, delivered, issued for delivery, continued or 
renewed in this State on or after January 1, 1997. 
For purposes 
of this section, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
The 
requirements 
of 
this 
section 
additionally 
apply 
to 
all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. C-7. 24-A MRSA §2847-G, sub-§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State after July 1, 2003. 
PARTD 
Sec. D-l. 24-A MRSA §4234-B, as amended by PL 2001, c. 258, 
Pt. A, §4, is further amended to read: 
§4234-B. Maternity and routine newborn care 
Individual 
and 
group 
contracts 
issued 
by 
a 
health 
maintenance 
organization 
that 
provide 
maternity 
benefits, 
inCluding benefits for childbirth, 
shall provide coverage for 
services related to maternity and routine newborn care, including 
coverage for hospital stay, 
in accordance with the attending 
physician I s or attending certified nurse midwife I s determination 
in conjunction with the mother that the mother and newborn meet 
the 
criteria outlined in the "Guidelines for Perinatal Care," 
published by the American Academy of Pediatrics and the American 
College of Obstetrics and Gynecology. 
For the purposes of this 
section, "routine newborn care" does not include any services 
provided after the mother has been discharged from the hospital. 
For the purposes of this section, "attending physician" includes 
the obstetrician, pediatrician or other physician attending the 
mother and newborn. 
Benefits for routine newborn care required 
by this section are part of the mother's benefit. 
The mother and 
the 
newborn 
are 
treated 
as 
one 
person 
in 
calculating 
the 
deductible, coinsurance and copayments for coverage required by 
this section. 
In addition to policies and contracts otherwise 
covered under this section, 
the requirements of this section 
apply 
to 
all 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State after July 1, 2003. 
Sec. D·2. 24·A MRSA §4234·C, last" as enacted by PL 1997, c. 
604, Pt. C, §4, is amended to read: 
The 
requirements of this section apply to all contracts 
delivered or issued for delivery in this State on 
or after ~ke 
eEEeet.,ive--da-t-e--eE--t-b:+s--Aet June 30, 1998. 
The requirements of 
this section additionally apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. D·3. 24·A MRS A §4237, sub·§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. D·4. 24·A MRSA §4237·A, sub·§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Sec. D·5. 24·A MRSA §4241, sub·§2, as enacted by PL 1995, c. 
617, §5 and affected by §6, is amended to read: 
2. 
Application. 
This section applies to all policies and 
contracts executed, delivered, issued for delivery, continued or 
renewed in this State on or after January 1, 1997. 
For purposes 
of this section, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
The 
requirements 
of 
this 
section 
additionally 
apply 
to 
all 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State after July 1, 2003. 
Sec. D·6. 24·A MRSA §4242, as reallocated by RR 1995, c. 2, 
§53, is amended to read: 
§4242. Coverage for Pap tests 
All 
health maintenance 
organization plan contracts 
must 
provide 
coverage 
for 
screening 
Pap 
tests 
recommended 
by 
a 
physician. 
In 
addition to 
policies 
and 
contracts 
otherwise 
covered under this section, 
the requirements of this section 
apply 
to 
all 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State after July 1, 2003. 
Sec. D-7. 24-A MRSA §4247, sub-§3 is enacted to read: 
3. 
Application to certificates. 
In addition to policies 
and 
contracts 
otherwise 
covered 
under 
this 
section, 
the 
requirements of this section apply to all certificates executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State after July 1, 2003. 
Emergency clause. 
In view of the emergency cited in the 
preamble, this Act takes effect when approved. 
SUMMARY 
The purpose of this bill is to ensure that Maine's women's 
health care coverage insurance mandates protect women living in 
Maine who are covered by an insurance certificate of coverage 
issued by an insurance carrier located in another state. 
Part A 
makes 
these 
changes 
in 
the 
section 
of 
the 
insurance 
code 
regulating nonprofit hospital and medical service organizations. 
Part B makes these changes in the section of the insurance code 
regulating individual health insurance policies. 
Part C makes 
these changes in the section of the insurance code regulating 
group health insurance policies. 
Part D makes these changes in 
the section of the insurance code regulating health maintenance 
organizations in Maine.