An Act To Require Health Insurers and Health Maintenance Organizations To Issue Uniform Prescription Drug Benefit Cards
Maine Legislature, Session 122, LD 0888
Committee: Insurance and Financial Services
Sponsors: MAYO, PERRY, MILLS, SULLIVAN, PILON, RICHARDSON
Amends: 24-A MRSA §4311-A

Legislative Document 
No. 888 
S.P.296 
In Senate, February 22, 2005 
An Act To Require Health Insurers and Health Maintenance 
Organizations To Issue Uniform Prescription Drug Benefit Cards 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Senator MAYO of Sagadahoc. 
Cosponsored by Representative PERRY of Calais and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: MILLS of Somerset, SULLIVAN of York, Representatives: PILON of Sa co, 
RICHARDSON of Warren. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §4311-A is enacted to read: 
§4311-A. Uniform prescription drug benefit information card 
1. Uniform information required. A carrier that issues a 
health plan that includes coverage for prescription drugs shall 
issue to its enrollees at the time of enrollment a card or other 
medium 
containing 
uniform 
standardized 
prescription 
drug 
information in a 
format approved by the superintendent. 
The 
carrier shall 
issue 
a 
revised card 
upon 
any 
change 
in the 
enrollee's information or other data included on the card. 
2. Minimum standards. At a minimum, a uniform prescription 
drug benefit card must contain the following information: 
A. 
The card issuer's name or logo on the front of the card; 
B. The enrollee's name and identification displayed on the 
front of the card; 
C. 
The enrollee's group number when required for proper 
claims administration: 
D. 
If applicable, the name and address of the benefits 
administrator or other entity responsible for prescription 
claims submission: and 
E. 
Any electronic transaction routing information and other 
information required by the carrier, benefits administrator 
or 
other 
entity 
to 
process 
a 
prescription 
claim 
electronically. 
3. Alternative format. The uniform prescription drug benefit 
information card or technology may be in a format approved by the 
National Council for Prescription Drug Programs or its successor 
organization if it includes all of the required data fields and 
complies with the most recent pharmacy identification card or 
technology implementation guide produced by the National Council 
for Prescription Drug Programs. 
4. Separate card not required. This section does not require 
a 
carrier to issue an identification card separate 
from~ 
identification card issued to an enrollee to evidence coverage 
under 
a 
health plan if the identification card contains the 
information required pursuant to subsection 2 or 3. 
5. Rules. 
The superintendent may adopt rules to implement 
the requirements of this section. Rules adopted pursuant to this 
subsection are routine technical rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
6. 
Application. 
This 
section 
applies 
to 
all 
policies, 
contracts 
and 
certificates 
executed, 
delivered, 
issued 
for 
delivery, continued or renewed in this State on or after January 
1, 2006. 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 
bill 
requires 
that 
health 
insurers 
and 
health 
maintenance organizations issue uniform prescription drug cards 
with standardized information relating to the prescription drug 
benefits provided under 
a 
health plan. 
The bill allows 
the 
standard information to be included on an existing identification 
card 
used 
by 
an 
insurer or 
health maintenance 
organization 
instead of 
requiring that the 
insurer or health maintenance 
organization issue 
a 
separate card. 
The bill applies to all 
policies, contracts and certificates issued on or after January 
1, 2006.