An Act To Ensure Women's Health Care Coverage for All Maine Women LR 1577(04)
Maine Legislature, Session 121, LD 1353
Committee Amendment CA_A_H648 (House)
Amends: 24 MRSA §2319, 24 MRSA §2332-F, 24 MRSA §2332-G, 24-A MRSA §2834, 24-A MRSA §2837, 24-A MRSA §4241, 24 MRSA §2318, 24 MRSA §2320-A, 24 MRSA §2320-B, 24 MRSA §2320-C, 24 MRSA §2325, 24 MRSA §2332, 24 MRSA §2332-M, 24-A MRSA §2846, 24-A MRSA §2847-G, 24-A MRSA §2847-H, 24-A MRSA §2847-I, 24-A MRSA §2847, 24-A MRSA §4234-B, 24-A MRSA §4237, 24-A MRSA §4237-A, 24-A MRSA §4246, 24-A MRSA §4248, 24-A MRSA §42, 24-A MRSA §4251, 24-A MRSA §4310, 24-A MRSA §4311, 24-A MRSA §4314, 24-A MRSA §4315

COMMITTEE AMENDMENT "/J,, to H.P. 995, L.D. 1353, Bill, "An 
Act To Ensure Women's Health Care Coverage for All Maine Women" 
Amend 
the 
bill 
in 
the 
emergency 
preamble 
in 
the 
2nd 
paragraph in the 3rd line (page 1, line 7 in L.D.) by striking 
out 
the 
following: 
"2003" 
and 
inserting in its place 
the 
following: '2004' 
Further amend the bill by striking out all of Parts A to D 
and inserting in their place the following: 
'PART A 
Sec. A·I. 24 MRSA §2319, first~, as amended by PL 1995, c. 
332, Pt. N, §1, is further amended to read: 
All 
individual 
and group nonprofit hospital 
and medical 
service organization contracts and certificates must provide that 
benefits are payable with respect to a newly born child from the 
moment of birth. 
Sec. A·2. 24 MRS A §2320·E, as enacted by PL 1995, c. 617, §1 
and affected by §6, is amended to read: 
COMMITTEE AMENDMENT 
\\,j~ 
COMMITTEE AMENDMENT .. ft.' to H.P. 995, L.D. 1353 
§2320-E. 
Coveraqe for Pap tests 
All 
group nonprofit medical 
service plan contracts 
and 
certificates and all nonprofit health care plan contracts and 
certificates 
must 
provide 
coverage 
for 
screening 
Pap 
tests 
recommended by a physician. 
Sec. A-3. 24 MRSA §2332-F, first 1(, as enacted by PL 1995, c. 
592, §l, is amended to read: 
All 
individual 
and group nonprofit hospital 
and medical 
services plan policies aBeL contracts and certificates and all 
nonprofit 
health 
care 
plan 
policies 
aBeL 
contracts 
and 
certificates must provide coverage for the medically appropriate 
and necessary equipment, limited to insulin, oral hypoglycemic 
agents, monitors, test strips, syringes and lancets, 
and the 
out-patient self-management training 
and educational 
services 
used to treat diabetes, if: 
Sec. A-4. 24 MRSA §2332-G, sub-§§l and 2, as reallocated by RR 
1995, c. 2, §49 and affected by §50, are amended to read: 
1. 
Coveraqe in managed care plans. 
With respect to managed 
care plans 
that require 
subscribers 
to select primary care 
physicians, a nonprofit hospital and medical service organization 
that issues 
group 
contracts 
and certificates must 
meet 
the 
following requirements. 
A. 
The organization must permit a physician who specializes 
in obstetrics and gynecology to serve as a 
primary care 
physician 
if 
the 
physician 
qualifies 
under 
the 
organization's credentialling policy. 
B. 
All group plan contracts must provide coverage for an 
annual gynecological examination, including routine pelvic 
and clinical breast examinations, performed by a physician, 
certified nurse 
practitioner or certified nurse 
midwife 
participating in the 
plan, 
without requiring the 
prior 
approval of the primary care physician. 
C. 
If the examination specified in paragraph B reveals a 
gynecological 
condition for 
which another visit to 
the 
physician participating in the plan is medically required 
and appropriate, or for any gynecological care beyond the 
annual examination, the carrier may require the patient or 
the examining physician, certified nurse practitioner or 
certified nurse midwife to secure from the patient's primary 
care physician a referral to the participating physician, 
certified nurse practitioner or certified nurse midwife from 
whom such care may be obtained. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. B 
.. to H.P. 995, L.D. 1353 
2. 
Application. 
This section applies to all contracts and 
certificates executed, delivered, issued for delivery, continued 
or renewed in this State 
eR-~~-~~~--~~-~7--199+. 
For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. A·5. 24·A MRSA §2834, first~, as amended by PL 1995, c. 
332, Pt. N, §3, is further amended to read: 
All 
group 
and 
blanket 
health 
insurance 
policies 
and 
certificates 
providing 
coverage 
on 
an 
eHpeRse---iReaFFee 
expense-incurred 
basis 
must 
provide 
that 
health 
insurance 
benefits are payable for a newly born child of the insured or 
subscriber from the moment of birth. An adopted child is deemed 
to be newly born to the adoptive parents from the date of the 
signed placement agreement. 
Preexisting conditions of an adopted 
child may not be excluded from coverage. 
Sec. A-6. 24-A MRSA §2834, last~, as amended by PL 1997, c. 
604, Pt. C, §3, is further amended to read: 
The requirements of this section apply to all policies and 
certificates delivered or issued for delivery in this State ffieFe 
thaR-l~O-eays-a~teF-the-e~~eetive-eate-e~-this-Aet. 
Sec. A-7. 24-A MRSA §2837·E, as enacted by PL 1995, c. 617, 
§3 and affected by §6, is amended to read: 
§2837-E. 
Coverage for Pap tests 
All group health insurance policies aaeL 
contractsT--e'K-eept 
aeeieeBtal---~&}~~Yr--~~~--~6ea6e, --he6p4~aJ---iaeemRitYT 
MeeieaFe-~~r-~~~~-ea~e--a&a-~~--J~mi~e£--eeaeEit 
health--i-n&tH'~-pe*ieies--and--eeRt~aetsT and certificates must 
provide 
coverage 
for 
screening 
Pap 
tests 
recommended 
by 
a 
physician. 
Sec. A·8. 24·A MRSA §2847-E, as enacted by PL 1995, c. 592, 
§3, is amended to read: 
§2847-E. Coverage for diabetes supplies 
All 
group 
insurance 
policies 
aReL 
contractsT--~~ee~t 
aeeieeata*---~&}~~Yr--~~-~--~6ea6e, --he6p4~aJ---iReeffiRitYT 
MeeieaFe-~~&r-~~~~-ea~e--a&a-~~--J~mi~~-eeReEit 
hea*th-...i-n&lH:'~-pe*ieies--and--eeRt"aet6T and certificates must 
provide 
coverage 
for 
the medically appropriate 
and 
necessary 
equipment, 
limited 
to 
insulin, 
oral 
hypoglycemic 
agents, 
monitors, test strips, syringes and lancets, and the out-patient 
COMMITTEE AMENDMENT 
~.co. 
COMMITTEE AMENDMENT .. if .. to H.P. 995, L.D. 1353 
self-management training and educational services used to treat 
diabetes, if: 
1. 
Certification of medical 
necessity. 
The 
insured's 
treating 
physician 
or 
a 
physician 
who 
specializes 
in 
the 
treatment of diabetes certifies that the equipment and services 
are necessary; and 
2. 
Provision of medical services. 
The diabetes out-patient 
self-management training and educational services are provided 
through ambulatory diabetes education facilities authorized by 
the State's Diabetes Control Project within the Bureau of Health. 
The 
requirements 
of 
this 
section 
apply 
to 
all 
group 
policies, contracts and certificates executed, delivered, issued 
for delivery, continued or renewed in this State. 
For purposes 
of this section, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
Sec. A·9. 24·A MRSA §2847.F, sub·§§l and 2, as reallocated by 
PL 1997, c. 370, Pt. H, §1, are amended to read: 
1. 
Coverage in managed care plans. 
With respect to managed 
care plans that require group members to select pr imary care 
physicians, 
an 
insurer 
that 
issues 
group 
health 
insurance 
policies aasL contracts and certificates must meet the following 
requirements. 
A. 
The insurer must permit 
obstetrics 
and 
gynecology 
physician if the physician 
credentialling policy. 
a physician who specializes in 
to 
serve 
as 
a 
primary 
care 
qualifies under the insurer's 
B. 
All group plan contracts must provide coverage for an 
annual gynecological examination, including routine pelvic 
and clinical breast examinations, performed by a physician, 
certified nurse practitioner or 
certified nurse 
midwife 
participating in the 
plan, 
without 
requiring 
the prior 
approval of the primary care physician. 
C. 
If the examination specified in paragraph B reveals a 
gynecological 
condition for 
which 
another visit to 
the 
physician participating in the plan is medically required 
and appropriate, or for any gynecological care beyond the 
annual examination, the carrier may require the patient or 
the exam1n1ng physician, certified nurse practitioner or 
certified nurse midwife to secure from the patient's primary 
care physician a referral to the participating physician, 
certified nurse practitioner or certified nurse midwife from 
whom such care may be obtained. 
COMMITTEE AMENDMENT 
\'w.'<;'. 
COMMITTEE AMENDMENT "It, to H.P. 995, L.D. 1353 
2. 
Application. 
This section applies to all policies aBS.L 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State eB-~-~~~--JaBQa~y 
lr-l991. 
For purposes of this section, all contracts are deemed 
to be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. A·10. 24·A MRSA §4240, as enacted by PL 1995, c. 592, 
§4, is amended to read: 
§4240. 
Coverage for diabetes supplies 
All health maintenance organization individual 
and group 
health contracts and certificates must provide coverage for the 
medically 
appropriate 
and 
necessary 
equipment, 
limited 
to 
insulin, 
oral 
hypoglycemic 
agents, 
monitors, 
test 
strips, 
syringes 
and 
lancets, 
and 
the 
out-patient 
self-management 
training and educational services used to treat diabetes, if: 
1. 
Certification of medical necessity. 
The 
enrollee's 
treating 
physician 
or 
a 
physician 
who 
specializes 
in 
the 
treatment of diabetes certifies that the equipment and services 
are necessary; and 
2. 
Provision of medical services. 
The diabetes out-patient 
self-management training and educational services are provided 
through ambulatory diabetes education facilities authorized by 
the State's Diabetes Control Project within the Bureau of Health. 
The 
requirements 
of 
this 
section 
apply 
to 
all 
group 
policies. contracts and certificates executed. delivered. issued 
for delivery. continued or renewed in this State. 
For purposes 
of this section. all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
Sec. A·H. 24-A MRSA §4241, sub-§§l and 2, as enacted by PL 
1995, c. 617, §5 and affected by §6, are amended to read: 
1. 
Coverage in managed care plans. 
With respect to managed 
care 
plans 
that 
require 
enrollees 
to 
select 
primary 
care 
physicians, a health maintenance organization that issues group 
policies aBS.L contracts and certificates must meet the following 
requirements. 
A. 
The 
health 
maintenance 
organization 
must 
permit 
a 
physician who specializes in obstetrics and gynecology to 
serve as a primary care physician if the physician qualifies 
under the organization's credentialling policy. 
COMMITTEE AMENDMENT 
tl\CO. 
~I' 
COMMITTEE AMENDMENT ,1(" to H. P. 995, L. D. 1353 
B. 
All group plan contracts must provide coverage for an 
annual gynecological examination, 
including routine pelvic 
and clinical breast examinations, performed by a physician, 
certified nurse practitioner or certified nurse 
midwife 
participating in the plan, 
without 
requiring the prior 
approval of the primary care physician. 
C. 
If the examination specified in paragraph B reveals a 
gynecological 
condition for 
which 
another visit to 
the 
physician participating in the plan is medically required 
and appropriate, or for any gynecological care beyond the 
annual examination, the carrier may require the patient or 
the 
exam1n1ng physician, 
certified nurse practitioner or 
certified nurse midwife to secure from the patient's primary 
care physician a referral to the participating physician, 
certified nurse practitioner or certified nurse midwife from 
whom such care may be obtained. 
2. 
Application. 
This section applies to all policies aaeL 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State ea-~-~~~--JaBQaFY 
±r-*99+. 
For purposes of this section, all contracts are deemed 
to be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. A-12. 24-A MRS A §4242, as reallocated by RR 1995, c. 2, 
§53, is amended to read: 
§4242. 
Coveraqe for Pap tests 
All 
health maintenance 
certificates 
must 
provide 
recommended by a physician. 
organization 
coverage 
for 
plan 
contracts 
and 
screening 
Pap 
tests 
Sec. A-13. Application. 
This Part applies to all policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State on or after July 1, 
2004. 
For purposes of this Part, all contracts are deemed to be 
renewed no later than the next yearly anniversary of the contract 
date. 
PARTB 
Sec. B-1. 24 MRSA §2318, sub-§6 is enacted to read: 
6. 
Application. 
The requirements of this section apply to 
all policies, 
contracts 
and certificates executed, 
delivered, 
issued for delivery, continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .. a· to H.P. 995, L.D. 1353 
Sec. B·2. 24 MRSA §2318·A, as amended by PL 2001, c. 258, Pt. 
A, §1, is further amended to read: 
§23l8-A. 
Maternity and routine newborn care 
A nonprofit hospital or medical service organization that 
issues individual and group contracts and certificates 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. 
Sec. B·3. 24 MRSA §2320-A, sub-§3, as enacted by PL 1989, c. 
875, Pt. I, §2, is amended to read: 
3. 
Application. 
This section applies to all policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State 98-9~-af~e~-Ma~eR-~T 
1991. 
For purposes of this section, all contracts are deemed to 
be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B·4. 24 MRSA §2320-B, as amended by PL 1995, c. 671, §8, 
is further amended to read: 
§2320-B. 
Acupuncture services 
All individual and group nonprofit medical services plan 
contracts and certificates and all nonprofit health care plan 
contracts 
and certificates providing coverage for acupuncture 
must provide coverage for those services when performed by an 
acupuncturist licensed pursuant 
to Title 
32, 
chapter 
113-B, 
subchapter II 2., 
under the same conditions that apply to the 
services of a licensed physician. 
Sec. B-S. 24 MRSA §2320-C, sub-§3 is enacted to read: 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT .~ to H.P. 995, L.D. 1353 
3. 
Application. 
The 
re~uirements of this section apply to 
all policies. contracts and certificates executed. 
delivered. 
issued for delivery, continued or renewed in this State. For 
purposes of this section. all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B-6. 24 MRSA §2325.A, sub-§10 is enacted to read: 
10. 
A221ication. 
Except 
as otherwise provided in this 
section. the re~uirements of this section apply to all policies. 
contracts 
and 
certificates 
executed. 
delivered. 
issued 
for 
delivery. continued or renewed in this State. For purposes of 
this section. all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
Sec. B-7. 24 MRSA §2332.J, sub·§3 is enacted to read: 
3. 
A221ication. 
The 
re~uirements of this section apply to 
all policies. contracts and certificates executed. 
delivered. 
issued for delivery. continued or renewed in this State. For 
purposes of this section. all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B·8. 24 MRSA §2332·K, sub-§4 is enacted to read: 
4. 
A221ication. 
The 
re~uirements of this section apply to 
all policies. contracts and certificates executed. 
delivered. 
issued for delivery, continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B-9. 24 MRSA §2332·L, sub·§5 is enacted to read: 
5. 
A221ication. 
The requirements of this section apply to 
all pOlicies, contracts and certificates executed. 
delivered. 
issued for delivery, continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B-I0. 24 MRSA §2332-M, sub-§6 is enacted to read: 
6. 
A221ication. 
The 
re~uirements of this section apply to 
all policies. contracts and certificates executed. 
delivered. 
issued for delivery. continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B-l1. 24·A MRSA §2832, as amended by PL 1979, c. 663, 
§146, is further amended to read: 
COMMITTEE AMENDMENT 
.~~ .. ~. 
COMMITTEE AMENDMENT ,,/(:. to H.P. 995, L.D. 1353 
§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 
aBQ-~laa6.L 
contracts 
and certificates shall 
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 
materni ty coverage. This requirement shall-apply applies to all 
group or blanket insurance written or renewed after the effective 
date of this Act, 
and shall--i-aelaae includes, but is not :ge 
limited to, all types and forms of group insurance issued by 
individual companies or corporations. 
Sec. B·12. 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 and certificates 
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 
Ca~e," 
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. 
Sec. B·13. 24·A MRSA §2835, sub·§§1 and 3, as amended by PL 
2003, c. 65, §2 and affected by §5, are further amended to read: 
1. 
Notwithstanding any provision of 
a 
health insurance 
policy or certificate issued under a group policy subject to this 
chapter, 
whenever 
the 
policy 
provides 
for 
payment 
or 
reimbursement for services that are within the lawful scope of 
practice of a psychologist licensed to practice in this State; a 
certified social worker licensed for the independent practice of 
COMMITTEE AMENDMENT 
~~. 
~~ 
COMMITTEE AMENDMENT "k- to H.P. 995, L.D. 1353 
social work in this State who has at least a masters degree in 
social work from an accredited educational institution, has been 
employed in social work for at least 2 years, and who, after 
January 1, 1985, must be licensed as a clinical social worker in 
this State; a licensed clinical professional counselor licensed 
for the independent practice of counseling who has at least a 
masters 
degree 
in counseling 
from 
an accredited educational 
institution, has been employed in counseling for at least 2 years 
and, 
after January 1, 
2002, 
must be licensed as 
a 
clinical 
professional counselor in this State; or a licensed nurse who is 
certified by the American Nurses' 
Association as 
a 
clinical 
specialist in adult psychiatric and mental health nursing or as a 
clinical 
specialist in child 
and 
adolescent psychiatric 
and 
mental 
health nursing, 
any person covered by 
the policy is 
entitled to reimbursement for these services if the services are 
performed by a physician; a psychologist licensed to practice in 
this State; a certified social worker licensed for independent 
practice in this State who has at least a masters degree in 
social work from an accredited educational institution, who has 
been employed in social work for at least 2 years, and who, after 
January 1, 1985, must be licensed as a clinical social worker in 
this State; a licensed clinical professional counselor licensed 
for the independent practice of counseling who has at least a 
masters 
degree 
in counseling 
from 
an accredited educational 
institution, has been employed in counseling for at least 2 years 
and, 
after January 1, 
2002, 
must be licensed as 
a clinical 
professional 
counselor 
in this 
State; 
or 
a 
licensed 
nurse 
certified by the American Nurses' 
Association as 
a 
clinical 
specialist in adult or child and adolescent psychiatric and 
mental health nursing. 
Payment or reimbursement for services 
rendered by clinical social workers licensed in this State, 
licensed clinical professional counselors licensed in this State 
or licensed nurses certified by the American Nurses' Association 
as 
clinical 
specialists 
in 
adult 
or 
child 
and 
adolescent 
psychiatric and mental health nursing may not be conditioned upon 
prior diagnosis or referral by a physician or other health care 
professional, except in cases where diagnosis of the condition 
for which the services are rendered is beyond the scope of their 
licensure. 
3. 
Mental 
health 
services 
provided 
by 
counseling 
professionals. 
Except as provided in subsection 1 with regard to 
reimbursement of clinical professional counselors licensed in 
this State, an insurer that issues group health care contracts 
providing 
coverage 
for 
mental 
health 
services 
shall 
make 
available 
coverage 
for 
those 
services 
when 
performed 
by 
a 
counseling professional who is licensed by the State pursuant to 
Title 32, 
chapter 119 to assess and treat interpersonal and 
intrapersonal 
problems, 
has 
at 
least 
a 
masters 
degree 
in 
counseling or a related field from an accredited educational 
COMMITTEE AMENDMENT 
~~. 
~... :\ 
COMMITTEE AMENDMENT ,,~ to H.P. 995, L.D. 1353 
institution and has been employed as a counselor for at least 2 
years. 
Any 
contract providing coverage for 
the services of 
counseling professionals pursuant to this section may be subject 
to 
any 
reasonable limitations, 
maximum benefits, 
coinsurance, 
deductibles 
or 
exclusion 
provisions 
applicable 
to 
overall 
benefits under the contract. 
This subsection applies to all 
policies. contracts and certificates executed, delivered, issued 
for delivery, continued or renewed in this State en--<H:"--a;E'toel= 
Jan~a~y-1T-±g9+. 
For purposes of this subsection, all contracts 
are deemed renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B·14. 24·A MRS A §2837·B, as amended by PL 1995, c. 671, 
§10, is further amended to read: 
§2837-B. 
Acupuncture services 
All 
group 
insurance policies 
and certificates providing 
coverage for acupuncture must provide coverage for those services 
when performed by an acupuncturist licensed pursuant to Title 32, 
chapter 113-B, subchapter II 2., under the same conditions that 
apply to the services of a licensed physician. 
Sec. B·15. 24·A MRSA §2837·C, sub·§3 is enacted to read: 
3. 
Application. 
The requirements of this section apply to 
all 
group 
policies. 
contracts 
and 
certificates 
executed. 
delivered. 
issued for delivery. 
continued or renewed in this 
State. For purposes of this section. all contracts are deemed to 
be 
renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B·16. 24·A MRSA §2843, sub·§8, as repealed and replaced 
by PL 1995, c. 407, §9, is amended to read: 
8. 
Application. 
This section does not apply to accidental 
lnJury, 
specified 
disease, 
hospital 
indemnity, 
Medicare 
supplement, 
long-term 
care 
or 
other 
limited benefit 
health 
insurance 
policies. 
Except 
as 
otherwise 
provided 
in 
this 
section. the requirements of this section apply to all policies. 
contracts 
and 
certificates 
executed. 
delivered. 
issued 
for 
delivery. continued or renewed in this State. For purposes of 
this section. all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date. 
Sec. B·17. 24-A MRSA §2846, as enacted by PL 1989, c. 176, 
§6, is amended to read: 
§2846. 
Acquired Immune Deficiency Syndrome 
Page l1-LR1577(4) 
COMMITTEE AMENDMENT 
«.. \i,\ ~. 
COMMITTEE AMENDMENT .. ~ to H.P. 995, L.D. 1353 
Ne A group health insurance policy or certificate delivered 
or issued for delivery in this State may 
not provide more 
restrictive benefits for sickness or disablement or the related 
expenses 
resulting 
from 
Acquired 
Immune 
Deficiency 
Syndrome 
(AIDS), AIDS Related Complex (ARC) or HIV related diseases than 
for any other sickness or disabling condition or exclude benefits 
for AIDS, ARC or HIV related diseases except through an exclusion 
under which all sicknesses and diseases are treated the same. 
This section saall does not apply to a policy providing benefits 
for specific diseases or accidental injury only. 
Sec. B-18. 24-A MRSA §2847-G, sub-§3 is enacted to read: 
3. 
Application. 
The requirements of this section apply to 
all policies, 
contracts and certificates executed, 
delivered, 
issued for delivery, continued or renewed in this State. For 
purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. B-19. 24-A MRSA §2847-H, sub-§4 is enacted to read: 
4. 
Application. 
The requirements of this section apply to 
all 
group 
policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State. For purposes of this section, all contracts are deemed to 
be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B-20. 24-A MRSA §2847-I, sub-§5 is enacted to read: 
5. 
Application. 
The requirements of this section apply to 
all 
group 
policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued for delivery, 
continued or renewed in this 
State. For purposes of this section, all contracts are deemed to 
be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B-21. 24·A MRSA §2847·J, sub·§3 is enacted to read: 
3. 
Application. 
The requirements of this section apply to 
all 
group 
policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State. For purposes of this section, all contracts are deemed to 
be 
renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B·22. 24-A MRSA §2847·K, sub·§6 is enacted to read: 
6. 
Application. 
The requirements of this section apply to 
all 
group 
policies, 
contracts 
and 
certificates 
executed, 
COMMITTEE AMENDMENT 
\\..~. 
COMMITTEE AMENDMENT "k' to H.P. 995, L.D. 1353 
delivered, 
issued for delivery, 
continued or 
renewed in this 
State. For purposes of this section, all contracts are deemed to 
be renewed no later than the next yearly anniversary of the 
contract date. 
Sec. B-23. 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 and certificates 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'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. 
Sec. B-24. 24-A MRSA §4237, sub-§3 is enacted to read: 
3. 
Application. 
The reguirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-25. 24-A MRSA §4237-A, sub-§3 is enacted to read: 
3. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-26. 24-A MRSA §4246, sub-§5 is enacted to read: 
COMMITTEE AMENDMENT 
~.~~ 
COMMITTEE AMENDMENT ,,~ to H.P. 995, L.D. 1353 
5. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B·27. 24·A MRSA §4247, sub-§3 is enacted to read: 
3. 
Application. 
The regui rements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered. issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-28. 24-A MRSA §4248, sub-§4 is enacted to read: 
4. 
Application. 
The requirements of this section apply to 
all individual and group policies. contracts and certificates 
executed, delivered, issued for delivery. continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-29. 24-A MRSA §42S0, sub-§3 is enacted to read: 
3. 
Application. 
The reguirements of this section apply to 
all individual and group policies. contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-30. 24-A MRSA §4251, sub-§6 is enacted to read: 
6. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery. continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-31. 24-A MRSA §4310, sub·§S is enacted to read: 
5. 
Application. 
The requirements of this section apply to 
all individual and group policies. contracts and certificates 
executed, delivered, issued for delivery. continued or renewed in 
this State. 
For purposes of this section. all contracts are 
COMMITTEE AMENDMENT 
· ~6fO. 
COMMITTEE AMENDMENT "if: to H.P. 995, L.D. 1353 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-32. 24-A MRSA §4311, sub-§4 is enacted to read: 
4. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-33. 24-A MRSA §4314, sub-§5 is enacted to read: 
5. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date. 
Sec. B-34. 24-A MRSA §4315, sub-§7 is enacted to read: 
7. 
Application. 
The requirements of this section apply to 
all individual and group policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in 
this State. 
For purposes of this section, all contracts are 
deemed to be renewed no later than the next yearly anniversary of 
the contract date,' 
SUMMARY 
This 
amendment 
replaces the bill, 
Part 
A extends the 
application of certain mandated health insurance benefits to 
certificates held in Maine that are issued by an out-of-state 
group health plan. 
These mandated benefits are coverage for 
newborns from the moment of birth, coverage for screening Pap 
tests, coverage for a self-referred annual gynecological exam and 
coverage for diabetic equipment and supplies. 
Part A applies to 
all policies, contracts and certificates issued or renewed on or 
after July 1, 2004. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "pr. to H.P. 995. L.D. 1353 
Part 
B clarifies 
the 
application of 
currently mandated 
benefits to certificates. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Approved: 01/08/04 frae 
Office of Fiscal and Program Review 
LD 1353 
An Act To Ensure Women's Health Care Coverage for All Maine 
Women 
LR 1577(04) 
Fiscal Note for Bill as Amended by Committee Amendment" " 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Minority Report 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Any additional costs to the Department of Professional and Financial Regulation in implementing this legislation can 
be absorbed by the department using existing resources. 
LR1577(4) - Fiscal Note - Page 1 of 1