An Act To Establish a Simplified Package of Health Care Insurance Affordable by All
Maine Legislature, Session 122, LD 1475
Committee: Insurance and Financial Services
Sponsors: JOY, FITTS, FLETCHER, HOTHAM, LANSLEY, LEWIN, RICHARDSON, SHIELDS, VAUGHAN
Amends: 22 MRSA §871, 24 MRSA §2317-B, 24 MRSA §2318, 24 MRSA §2318-A, 24 MRSA §2319, 24 MRSA §2320, 24 MRSA §2320-A, 24 MRSA §2320-B, 24 MRSA §2320-C, 24 MRSA §2320-E, 24 MRSA §2324, 24 MRSA §2325-A, 24 MRSA §2325-C, 24 MRSA §2329, 24 MRSA §2331, 24 MRSA §2332-B, 24 MRSA §2332-F, 24 MRSA §2332-G, 24 MRSA §2332-J, 24 MRSA §2332-K, 24 MRSA §2332-L, 24 MRSA §2332-M, 24-A MRSA §2412, 24-A MRSA §2741, 24-A MRSA §2742, 24-A MRSA §2743, 24-A MRSA §2743-A, 24-A MRSA §2744, 24-A MRSA §2745-A, 24-A MRSA §2745-B, 24-A MRSA §2745-C, 24-A MRSA §2745-D, 24-A MRSA §2745-E, 24-A MRSA §2745-F, 24-A MRSA §2745-G, 24-A MRSA §2748, 24-A MRSA §2749-C, 24-A MRSA §2754, 24-A MRSA §2756, 24-A MRSA §2757, 24-A MRSA §2758, 24-A MRSA §2759, 24-A MRSA §2760, 24-A MRSA §2832, 24-A MRSA §2833, 24-A MRSA §2834, 24-A MRSA §2834-A, 24-A MRSA §2835, 24-A MRSA §2837-A, 24-A MRSA §2837-B, 24-A MRSA §2837-C, 24-A MRSA §2837-D, 24-A MRSA §2837-E, 24-A MRSA §2837-F, 24-A MRSA §2847, 24-A MRSA §2847-H, 24-A MRSA §2847-J, 24-A MRSA §2847-K, 24-A MRSA §4222, 24-A MRSA §4229, 24-A MRSA §4234, 24-A MRSA §4234-A, 24-A MRSA §4234-B, 24-A MRSA §4234-C, 24-A MRSA §4237, 24-A MRSA §4237-A, 24-A MRSA §4238, 24-A MRSA §4240, 24-A MRSA §4241, 24-A MRSA §4242, 24-A MRSA §4244, 24-A MRSA §4246, 24-A MRSA §4247, 24-A MRSA §4248, 24-A MRSA §4250, 24-A MRSA §4251, 24-A MRSA §4310, 24-A MRSA §4311, 24-A MRSA §4314, 24-A MRSA §5051

Legislative Document 
No. 1475 
H.P.1038 
House of Representatives, March 24, 2005 
An Act To Establish a Simplified Package of Health Care Insurance 
Affordable by All 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative JOY of Crystal. 
'71/~ 117.7il~~ 
MILLICENT M. MacFARLAND 
Clerk 
Cosponsored by Representatives: FITTS of Pittsfield, FLETCHER of Winslow, HOTHAM of 
Dixfield, LANSLEY of Sabattus, LEWIN of Eliot, RICHARDSON of Skowhegan, SHIELDS 
of Auburn, VAUGHAN of Durham. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. I. 22MRSA§3I73-D, as enacted by PL 1983, c. 752, §1, 
is amended to read: 
§3173-D. 
Reimbursement for alcoholism and drug dependency 
treatment 
The department shall provide reimbursement, to the maximum 
extent allowable, under the United States Social Security Act, 
Ti tIe 
XIX, 
for 
alcoholism 
and 
drug 
dependency 
treatment. 
Treatment 
shall ~ 
include, 
but 
need 
not 
be 
limited 
to, 
residential treatment and outpatient care 
as--de-~i-ne4--i*--±i1::l:e 
64-AT-see~ieB-6846. 
For purposes of this section, the following terms have the 
following meanings. 
1. 
Outpatient care. 
"Outpatient care" means care rendered 
by 
a 
state-licensed, 
approved 
or 
certified 
detoxification L 
residential 
treatment 
or 
outpatient 
program 
or 
partial 
hospitalization program on a periodic basis, including, but not 
limited 
to, 
patient 
diagnosis, 
assessment 
and 
treatment: 
individual, 
family 
and group counseling: 
and educational 
and 
support services. 
2. 
Residential treatment. 
"Residential treatment" 
means 
services at a facility that provides care 24 hours daily to one 
or more patients, including, but not limited to, the following 
services; 
room and board: medical, nursing and dietary services: 
patient diagnosis, assessment and treatment; individual, family 
and 
group 
counseling; 
and 
educational 
and 
support 
services, 
including a designated unit of a licensed health care facility 
providing any other services specified in this subsection to 
patients with the illnesses of alcoholism and drug dependency. 
Sec. 2. 22 MRSA §871l. sub-§2. as amended by PL 1999, c. 353, 
§16, is further amended to read: 
2. 
Information on mandated services. 
The organization is 
authorized 
and 
directed 
to 
require 
providers 
of 
mammography 
services to furnish information with respect to those services 
for the purpose of assisting in the evaluation of the social and 
financial impact and the efficacy of 1:he--manda-t-€4--bene-f-i-t--t9F 
screening mammograms 
l:lBEleF--~.i_t;.1e_-_24-,--see~ieB-~J..6.O..__A.-_ane_-±i~:l:e 
64-AT--&e(l-t-ions--6149-A--and--68~7-A. 
The information that may be 
collected 
includes 
the 
location 
of 
mammography 
units, 
the 
purchase of new mammography units, the number of screening and 
diagnostic mammograms performed, the charge per mammogram and the 
method and amount of payment, and the number of cancers detected 
by screening mammograms. 
Sec. 3. 24 MRS A §2317-B. sub-§§9 and 11, as enacted by PL 1999, 
c. 256, Pt. M, §10, are repealed. 
Sec. 4. 24 MRSA §2317-B. sub-§12-A. as enacted by PL 2001, c. 
358, Pt. LL, §1 and affected by §5, is repealed. 
Sec. 5. 24 MRSA §2317-B, sub-§16-A, as enacted by PL 2001, c. 
258, Pt. G, §2, is repealed. 
Sec. 6. 24 MRSA §2318. as amended by PL 2003, c. 517, Pt. B, 
§1, is repealed. 
Sec. 7. 24 MRSA §2318-A. as amended by PL 2003, c. 517, Pt. 
B, §2, is repealed. 
Sec. 8. 24 MRSA §2319, as amended by PL 2003, c. 517, Pt. A, 
§1 and affected by §13, is repealed. 
Sec. 9. 24 MRSA §2320. as amended by PL 1977, c. 696, §201, 
is repealed. 
Sec. 10. 24 MRSA §2320-A, as amended by PL 2003, c. 517, Pt. 
B, §3 and c. 689, Pt. B, §6, is repealed. 
Sec. 11. 24 MRSA §2320-B, as amended by PL 2003, c. 517, Pt. 
B, §4, is repealed. 
Sec. 12. 24 MRSA §2320-C. as amended by PL 2003, c. 517, Pt. 
B, §5, is repealed. 
Sec. 13. 24 MRSA *2320-D, as renumbered by RR 
1995, c. 1, 
§13, is repealed. 
Sec. 14. 24 MRSA §2320-E. as amended by PL 2003, c. 517, Pt. 
A, §2 and affected by §13, is repealed. 
Sec. 15. 24 MRSA §§2320-F and 2320-G. as enacted by PL 1997, 
c. 701, §1, are repealed. 
Sec. 16. 24 MRSA §2324. as enacted by PL 1979, c. 
and 
amended by PL 2003, c. 689, Pt. B, §6, is repealed. 
Sec. 17. 24 MRSA §2325-A. as amended by PL 2003, c. 517, Pt. 
B, §6 and c. 689, Pt. B, §6, is repealed. 
Sec. 18. 24 MRSA §2325-C. as enacted by PL 1997, c. 754, §1, 
is repealed. 
Sec. 19. 24 MRSA §2329. as amended by PL 1989, c. 490, §2, is 
repealed. 
Sec. 20. 24 MRSA §2331, as reallocated by PL 1981, c. 698, 
§107, is repealed. 
Sec. 21. 24 MRSA §2332-B. as repealed and replaced by PL 
1991, c. 3, §2, is repealed. 
Sec. 22. 24 MRSA §2332-F, as amended by PL 2003, c. 517, Pt. 
A, §3 and affected by §13, is repealed. 
Sec. 23. 24 MRSA §2332-G, as amended by PL 2003, c. 517, Pt. 
A, §4 and affected by §13, is repealed. 
Sec. 24. 24 MRSA §2332-J. as amended by PL 2003, c. 517, Pt. 
B, §7, is repealed. 
Sec. 25. 24 MRSA §2332-K, as amended by PL 2003, c. 517, Pt. 
B, §8, is repealed. 
Sec. 26. 24 MRSA §2332-L. as amended by PL 2003, c. 517, Pt. 
8, §9, is repealed. 
Sec. 27. 24 MRSA §2332-M, as amended by PL 2003, c. 517, Pt. 
8, §10, is repealed. 
Sec. 28. 24-A MRSA §2412, sub-§l-A, ~D. as enacted by PL 1997, 
c. 370, Pt. G, §2, is amended to read: 
D. 
The superintendent may disapprove a form filed pursuant 
to this subsection only if: 
(1) 
The policy or form is not in compliance with the 
laws of the state in which it was issued or delivered; 
(2) 
The policy or form is not in compliance with the 
laws of this State that apply when the policy is issued 
outside this State, such as chapter 36 
e~-see~~eB-~846; 
or 
(3) 
The superintendent determines that the 
form is 
deceptive or misleading. 
Sec. 29. 24-A MRSA §2741. as enacted by PL 1975, c. 276, §2, 
is repealed. 
Sec. 30. 24-A MRSA §2742. as amended by PL 1997, c. 795, §§8 
and 9 and PL 2003, c. 689, Pt. 8, §6, is repealed. 
Sec. 31. 24-A MRSA §2743. as amended by PL 1997, c. 604, Pt. 
C, §2, is repealed. 
Sec. 32. 24-A MRSA §2743-A, as amended by PL 2001, c. 258, 
Pt. A, §2, is repealed. 
Sec. 33. 24-A MRSA §2744, as amended by PL 2003, c. 65, §l 
and affected by §5, is repealed. 
Sec. 34. 24-A MRS A §2745, as enacted by PL 1977, c. 470, §2, 
is repealed. 
Sec. 35. 24-A MRSA §2745-A, as amended by PL 1997, c. 408, 
§3 and affected by §8 and amended by PL 2003, c. 689, Pt. B, §6, 
is repealed. 
Sec. 36. 24-A MRSA §2745-B. as amended by PL 1995, c. 671, 
§9, is repealed. 
Sec. 37. 24-A MRSA §2745-C. as repealed and replaced by PL 
1997, c. 408, §4 and affected by §8, is repealed. 
Sec. 38. 24-A MRSA §2745-D, as renumbered by RR 1995, c. l, 
§15, is repealed. 
Sec. 39. 24-A MRSA §2745-E. as enacted by PL 1997, c. 70l, 
§2, is repealed. 
Sec. 40. 24-A MRSA §2745-F. as enacted by PL 1997, c. 70l, 
§2, is repealed. 
Sec. 41. 24-A MRSA §2745-G. as reallocated by RR 1997, c. 2, 
§5l, is repealed. 
Sec. 42. 24-A MRSA §2748. as amended by PL 1993, c. 669, §2, 
is repealed. 
Sec. 43. 24-A MRSA §2749-C. as amended by PL 2003, c. 20, 
Pt. VV, §§8 and 9 and affected by §25, is repealed. 
Sec. 44. 24-A MRS A §2750. as enacted by PL 1989, c. 176, §5, 
is repealed. 
Sec. 45. 24-A MRSA §2754, as enacted by PL 1995, c. 592, §2, 
is repealed. 
Sec. 46. 24-A MRSA §2756. as enacted by PL 1999, c. 341, §2 
and affected by §5, is repealed. 
Sec. 47. 24-A MRSA §2757~ as reallocated by RR 1999, c. 1, 
§32, is repealed. 
Sec. 48. 24-A MRSA §2758. as reallocated by RR 1999, c. 1, 
§33, is repealed. 
Sec. 49 .. 24-A MRSA §2759. as enacted by PL 2001, c. 358, Pt. 
LL, §2 and affected by §5, is repealed. 
Sec. 50. 24-A MRSA §2760. as reallocated by RR 2001, c. 1, 
§31, is repealed. 
Sec. 51. 24-A MRSA §2832. as amended by PL 2003, c. 517, Pt. 
B, §11, is repealed. 
Sec. 52. 24-A MRSA §2833, as amended by PL 1993, c. 666, Pt. 
A, §§5 and 6, is repealed. 
Sec. 53. 24-A MRSA §2834. as amended by PL 2003, c. 517, Pt. 
A, §§5 and 6 and affected by §13, is repealed. 
Sec. 54. 24-A MRSA §2834-A. as amended by PL 2003, c. 517, 
Pt. B, §12, is repealed. 
Sec. 55. 24-A MRSA §2835. as amended by PL 2003, c. 517, Pt. 
B, §13, is repealed. 
Sec. 56. 24-A MRS A §2837. as amended by PL 1977, 
c. 
696, 
§202, is repealed. 
Sec. 57. 24-A MRSA §2837-A. as amended by PL 1997, c. 408, 
§5 and affected by §8 and amended by PL 2003, c. 689, Pt. B, §6, 
is repealed. 
Sec. 58. 24-A MRSA §2837-B. as amended by PL 2003, c. 517, 
Pt. B, §14, is repealed. 
Sec. 59. 24-A MRSA §2837-C, as amended by PL 2003, c. 517, 
Pt. B, §15, is repealed. 
Sec. 60. 24-A MRSA §2837-D, as renumbered by RR 1995, c. L 
§17, is repealed. 
Sec. 61. 24-A MRSA §2837-E. as amended by PL 2003, c. 517, 
Pt. A, §7 and affected by §13, is repealed. 
Sec. 62. 24-A MRSA §2837-F, as enacted by PL 1997, c. 701, 
§3, is repealed. 
Sec. 63. 24·A MRSA §2837·G, as enacted by PL 1997, c. 701, 
§3, is repealed. 
Sec. 64. 24·A MRSA §2837·H, as reallocated by RR 1997, c. 2, 
§52, is repealed. 
Sec. 65. 24·A MRSA §2840·A, as amended by PL 1993, c. 669, 
§3, is repealed. 
Sec. 66. 24·A MRSA §2842, as amended by PL 1989, c. 490, §3, 
is repealed. 
Sec. 67. 24·A MRSA §2843, as amended by PL 2003, c. 517, Pt. 
B, §16 and c. 689, Pt. B, §6, is repealed. 
Sec. 68. 24·A MRSA §2845, as enacted by PL 1987, c. 293, §2, 
is repealed. 
Sec. 69. 24·A MRSA §2846, as amended by PL 2003, c. 517, Pt. 
B, §17, is repealed. 
Sec. 70. 24-A MRSA §2847·E~ as amended by PL 2003, c. 517, 
Pt. A, §8 and affected by §13, is repealed. 
Sec. 71. 24·A MRSA §2847·F, as amended by PL 2003, c. 517, 
Pt. A, §9 and affected by §13, is repealed. 
Sec. 72. 24·A MRSA §2847·G, as amended by PL 2003, c. 517, 
Pt. B, §18, is repealed. 
Sec. 73. 24-A MRSA §2847-H. as amended by PL 2003, c. 517, 
Pt. B, §19, is repealed. 
Sec. 74. 24-A MRSA §2847.1. as amended by PL 2003, c. 
517, 
Pt. B, §20, is repealed. 
Sec. 75. 24-A MRSA §2847-J. as amended by PL 2003, c. 517, 
Pt. B, §21, is repealed. 
Sec. 76. 24-A MRSA §2847-K. as amended by PL 2003, c. 517, 
Pt. B, §22, is repealed. 
Sec. 77. 24-A MRSA §4222·B. sub-§l1. as enacted by PL 1997, c. 
445, §31 and affected by §32, is amended to read: 
11. 
The requirements of seet::i:eHs--6-8-3-4--asa section 2834-B 
apply to health maintenance organizations. 
Sec. 78. 24-A MRS A §4222-B. sub·§14. as amended by PL 2001, c. 
258, Pt. G, §3, is repealed. 
Sec. 79. 24-A MRSA §4229. as enacted by PL 1989, c. 176, §9, 
is repealed. 
Sec. 80. 24-A MRSA §4234. as amended by PL 1993, c. 666, Pt. 
A, §§7 and 8 and Pt. B, §3, is repealed. 
Sec. 81. 24-A MRSA §4234-A, as amended by PL 2003, c. 65, §3 
and affected by §5 and amended by c. 689, Pt. B, §6, is repealed. 
Sec. 82. 24-A MRSA §4234-B. as amended by PL 2003, c. 517, 
Pt. B, §23, is repealed. 
Sec. 83. 24-A MRSA §4234-C, 3rd~, as enacted by PL 1997, c. 
604, Pt. C, §4, is amended to read: 
If payment of 
a 
specific premium or subscription fee is 
required to provide 
coverage 
for 
a 
child, 
the 
contract 
may 
require that notification of birth of a 
newly born child and 
payment of the required fees must be furnished to the nonprofit 
hospital or medical service organization within 31 days after the 
date of birth in order to have the coverage continue beyond that 
31-day period. 
The payment may be required to be retroactive to 
the date of birth. 
8eRe€i~6--r~-r-€-d--b-y--6ee~iElR-42-J.4---.B.--il\U-&t"".-8e 
paiQ-Fe~aFQ~eSs-e€-wae~aeF-eeveFa~e-~RQeF-~ais-see~ieR-is-e~ee~eQT 
Sec. 84. 24-A MRSA §§4234-D and 4234-E. as enacted by PL 
1997, c. 701, §4, are repealed. 
Sec. 85. 24-AMRSA§4236. as amended by PL 1997, c. 99, §L 
is repealed. 
Sec. 86. 24-A MRSA §4237. as amended by PL 2003, c. 517, Pt. 
B, §24, is repealed. 
Sec. 87. 24-A MRSA §4237-A, as amended by PL 2003, c. 517, 
Pt. B, §25 and c. 689, Pt. B, §6, is repealed. 
Sec. 88. 24-A MRSA §4238, as renumbered by RR 1995, c. 
L 
§19, is repealed. 
Sec. 89. 24-A MRSA §4240. as amended by PL 2003, c. 517, Pt. 
A. §10 and affected by §13. is repealed. 
Sec. 90. 24-A MRSA §4241, as amended by PL 2003, c. 517, Pt. 
A, §11 and affected by §13, is repealed. 
Sec. 91. 24-A MRSA §4242. as amended by PL 2003, c. 517, Pt. 
A, §12 and affected by §13, is repealed. 
Sec. 92. 24-A MRSA §4244, as reallocated by RR 1997, c. 2, 
§53, is repealed. 
Sec. 93. 24-A MRSA §4246. as amended by PL 2003, c. 517, Pt. 
B, §26, is repealed. 
Sec. 94. 24-A MRSA §4247. as amended by PL 2003, c. 517, Pt. 
B, §27, is repealed. 
Sec. 95. 24-A MRSA §4248. as amended by PL 2003, c. 517, Pt. 
B, §28, is repealed. 
Sec. 96. 24-A MRSA §4250, as amended by PL 2003, c. 517, Pt. 
B, §29, is repealed. 
Sec. 97. 24-A MRSA §4251, as amended by PL 2003, c. 517, Pt. 
B, §30, is repealed. 
Sec. 98. 24-A MRSA §4310. as amended by PL 2003, c. 517, Pt. 
B, §31, is repealed. 
Sec. 99. 24-A MRSA §4311. as amended by PL 2003, c. 517, Pt. 
B, §32, is repealed. 
Sec. 100. 24-A MRSA §4314. as amended by PL 2003, c. 517, Pt. 
B, §33 and affected by §2, is repealed. 
Sec. 101. 24-A MRSA §5051. sub§§4 and 5. as enacted by PL 
1989, c. 556, Pt. B, §2, are amended to read: 
4. 
Home health care provider. 
"Home health care provider" 
Ra6-~~~-meaBiB~-~~~-~e~~R-~~-~~-6+49 means a home 
health care agency certified under Title XVIII of the Social 
Security Act of 1965, as amended, that: 
A. 
Is primarily engaged in and licensed or certified to 
provide skilled nursing and other therapeutic services; 
B. 
Has 
standards. 
policies 
and 
rules established by 
a 
professional 
group 
associated 
with 
the 
agency 
or 
organization. which professional group must include at least 
one physician and one registered nurse; 
C. 
Is available 7 days per week to provide the care needed 
in the home and has telephone answering service available 24 
hours per day; 
D. 
Provides, 
either directly or 
through 
contract. 
the 
services of a coordinator responsible for case discovery and 
planning and ensuring that the covered person receives the 
services ordered by the physician: 
I::. 
Has under contract the services of a physician or a 
physician-advisor licensed by the State: 
F. 
Conducts periodic case conferences for the purpose of 
individualized patient care planning and utilization review: 
and 
G. 
Maintains a complete medical record on each patient. 
5. 
Borne health care services. 
"Home health care services" 
Ras-~he-~~~-&~-se~-fe~~R-~£-~~~~~~r-&~~&ee&i~a&-± 
aRa-~~-~-6Ra6-~~~~~r~~-e~-~e£~~~~~~r-s~Bsee6ieR 
±T--par~-aph--A--6Ra.,l.,l-~-app±y means those health care services 
rendered in a person's place of residence on a~art-time basis tQ 
a 
covered person only if the plan covering the 
home health 
services is established as prescribed in writing by a physician. 
There is no reguirement that hospitalization be an antecedent to 
coverage under the policy. 
"Home health care services" includes: 
A. 
Visits by a registered nurse or licensed practical nurse 
to carry out treatments prescribed or supportive nursing 
care and observation as indicated: 
B. 
A physician's home or office visits or both: 
C. 
Visits by a registered physical, speech, occupational, 
inhalation 
or 
dietary 
therapist 
for 
services 
or 
for 
evaluation of, consultation with and instruction of nurses 
in 
carrying 
out 
therapy 
prescribed 
by 
the 
attending 
physician, or both; 
D. 
Any prescribed laboratory tests and x-ray examination 
using hospital or community facilities, 
drugs, 
dressings, 
oxygen or medical appliances and eguipment as prescribed by 
a physician, but only to the extent that such charges would 
have been covered under the contract if the covered person 
had remained in the hospital: and 
E. 
Visits by persons who have completed a home health aide 
training course under the supervision of a registered nurse 
for the purpose of giving personal care to the patient and 
performing light household tasks as reguired by the plan of 
care, but not including services. 
SUMMARY 
The 
purpose of this bill is 
to 
allow health insurance 
carriers to offer a simple package of basic health care insurance 
that is affordable for more of the citizens of the State. 
The 
bill repeals existing state-mandated benefits, mandated health 
insurance coverage and mandated offerings of health benefits. 
This 
bill 
also 
makes 
cross-reference 
corrections 
necessitated by the repeal of various provisions of law.