An Act To Establish the Universal Childhood Immunization . Program Reference. to·the Committee on Health and Hltman Services suggested and ordered printed.
Maine Legislature, Session 124, LD 1408
Committee: Health and Hltman Services
Sponsors: CONNOR, MARRACHE, BERRY, EVES, MILLER, PERRY, PINGREE, STRANG BURGESS, BRYANT, MILLS, MITCHELL
Amends: 5 MRSA §12004-G, 22 MRSA §1066

FIRST F..EGULAR SESSION-2009 
Legislative Document 
No. 1408 
H.P.984 
House of Representatives, April 6, 2009 
An Act To Establish the Universal Childhood Immunization 
. Program 
Reference. to·the Committee on Health and Hltman Services suggested and ordered printed. 
Presented by Representative CONNOR of Kennebunk. 
Cosponsored by Senator MARRACHE of Kennebec and 
IY/!.-~ 111· mll£;ftvJ~{ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BERRY of Bowdoinham, EVES of North Berwick, MILLER of Somerville, 
PERRY of Calais, Speaker PINGREE of North Haven, STRANG BURGESS of Cumberland, 
Senators: BRYANT of Oxford, MILLS of Somerset,President MITCHELL of Keimebec. 
Printed Ill! r~cyd~t1 p.lper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 5 MRSA §12004-G, sub-§15-B is enacted to read: 
lS-B. 
Human Services: 
Maine Vaccine 
Expenses Only 
Immunization 
Board 
Sec. 2. 22 MRSA §1066 is enacted to read: 
§1066. Universal Childhood Immunization Program 
MRSA § I 066 
1.. 
Program established. 
The Universal' Childhood Immunization Program, 
administered by the board, is established to provide universal immunization coverage to 
children in the State. 
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2. Definitions. As used in this section, unless the con'text otherwise indicates, the 
following terms have the following meanings. 
A. "Advisory committee" means the Advisory Committee on Immunization Practices 
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of the United States Department of Health and Human Services, Centers for Disease 
IS 
Control and Prevention, or successor organization. 
B. "Board" means the Maine Vaccine Board under subsection 3. 
C. "Covered life months" means the number of months during a calendar year that a 
person is covered under a health insurance plan provided by a health insurer. 
D. "Fund" means the Childhood Immunization Fund established in subsection 10. 
E. 
"Health insurer" means a health insurance carrier, 3rd-paliy administrator and 
employee benefit excess insurance can'ier subject to the provisions of Title 24-A; 
section 6913, subsection 3. 
F. "Program" means the Universal Childhood Immtlnization Program established in 
subsection 1. 
G. "Superintendent" means the Superintendent of Insurance. 
3. Maine Vaccine Board. The Maine Vaccine Board is established pursuant to Title 
5, section 12004-G, subsection I5-B and is organized as follows. 
A. The board must have 9 members, 7 of whom are appointed by the Govemor, 
including 3 representatives of the health insurers who insure the 3 most covered life 
months in the State, 3 representatives of health care providers in the State and a 
member of the general public. The commissioner and the superintendent serve as ex 
officio members of the board. The term of an appointed member to the board is 3 
years. The board shall elect a chair from among its members. 
B. The board shall administer the program, the .provisions of this section and the 
fund. The board may assess a fine pursuant to subsection 8. 
C. The department shall staff and provide administrative support for the board. 
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4. Program requirements. The program shall purchase and make available to a' 
health care provider every vaccine for childhood immunization that is recommended by 
the advisory committee, approved by the United' States Food and Drug Administration 
and available under contract with the United States Department of Health and Human 
Services, Centers for Disease Control and Prevention and that is not funded by the 
Vaccines for Children Program of the United States Department of Health and Human 
Services, Centers for Disease Control and Prevention, or successor program. A health 
care provider who provides a childhood vaccine under this subsection must participate in 
the Maine Center for Disease Control and Prevention's Immunization program. Upon 
request, the department shall make available to a health insurer information about the 
program and the costs associated with the program. 
S.Funding. Program costs must be funded from the fund each year in an amOlint 
equal to the dollar amount necessary to purchase, store, distribute and provide quality 
assurance for every vaccine under subsections 4 and 7 for routine immunization of all 
children in the State in accordance with the application recommended by the advisory 
committee minus the dollar amount necessary to covel' all children in the State for every 
vaccine recommended under the Vaccines for Children Program of the United, States 
Department of Health and Human Services; Centers for Disease Control and Prevention 
and any amount in the fund assessed but not needed to cover program costs for the prior 
year. The board shall determine the amount of the program costs required by this 
subsection for a vaccine under subsection 4 no later than October 1 st of every year. 
6. Assessment. A health insurer shall pay an annual assessment as set out in this 
subsection. In administering a health insurer assessment under the program, the board 
shall: 
A. After an opportunity for a hearing conducted pursuant to Title 5, chapter 375, 
subchapter 4, determine an assessment amount equal to the ratio of the' pro grain costs 
calculated under subsection 5 to the total number of covered life' months of 
nonelderly residents in the State of all health insurers for the prior year; and 
B. By January 1st, send notice of an assessment to a health insurer in an amount 
equal to the assessment amount under paragraph A multiplied by the total number' of 
covered life months of nonelderly residents in the State covered by the health insurer 
for the prior year. The assessment must be paid to the board by the health insurer by 
April 1st. ' 
An assessment received by the board under paragraph B must be credited to the fund. 
7. 
New vaccine assessment. Fora new vaccine recommended by the advisory 
committee for which an initial federal contract price is established between October 1 st 
and July 1 st of a fiscal year: 
A. The board shall calculate the program cost for the vaccine under subsection 4 by 
the first day of the calendar quarter following the establishment of the federal 
contract price; and 
B. Within 90 days after calculating the program cost under paragraph A, after an 
opportunity for a hearing conducted pursuant to Title 5, chapter' 375, subchapter 4, 
the board shall determine an assessment amount equal to the ratio of the program cost 
Pag.: 2 - 124LRI4S9(OI)-1 
calculated under paragraph A divided by the total number of covered life months of 
nonelderly residents in the State for the calendar quarter under paragraph A and send 
notice of an assessment to a health insurer in the am'ount equal to theassessmelit 
amount multiplied by the total number of covered months of nonelderly residents in 
the State covered by the health insurer for that calendar qUaJier. 
. 
An assessment under this subsection mus't be paid by a health insurer to the board within 
days after receipt of the notice under paragraph B. The assessment must be credited to 
the fund. 
8. Failure to pay assessment. After April 1 st for an assessment under subsection 6 
and after 90 days after notice of an assessment under subsection 7, paragraph B, the board 
shall submit a report to the superintendent listing every health insurer that failed to remit 
an assessment. The board shall notify each health insurer in the report that the health 
insurer has 90 days to either remit the assessment due or enter into an assessment 
payment plan approved by the board. Ira health ·insurer has not paid an assessment under 
subsection 6 or 7 within 6 months of notification, the board may assess a fine of up to 
125% of the amount of the delinquent assessment. A fine paid under this subsection must 
be deposited into the fund. The superintendent may suspend or revoke, after· notice and 
hearing, the certificate of authority to transact insurance in this State of any health insurer 
. to operate in this State that fails to pay an assessment under subsection' 6 or 7 and may 
assess a fine other than the fine required by this subsection against any health insurer that 
fails to pay an assessment under subsection 6 or 7 or mav take any other enforcement 
action authorized under Title 24-A, section 12-A to collect any unpaid assessment under. 
subsection 6 or 7. 
9. Reporting. The board may require a health insurer to report the number of 
covered life months covered by the health insurer for a calendar period on a form and a 
schedule determined by the board. 
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.. Fund. The Childhood Immu'nization Fund is established to fund the purposes of 
the program under subsection 4 and the costs of administration ofthe program and the 
board. The fund is administered by the board. All assessments collected pursuant to this 
section must be deposited into the fund as well as income from any other source directed 
to the fund. All interest earned by the fund becomes part of the fund. Any balance 
remaining in the fund at the end of the fiscal year does not lapse but is carried forward 
into subsequent fiscal years. 
11. Rules. The board may adopt rules to carry out the purposes of this section. Rules 
adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 
. 36 
375, subchapter 2-A. 
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SUMMARY 
This bill creates the l)niversaL Childhood Immunization Program to provide 
immunizations and cover the costs of recommended vaccines for children in the State not 
covered by the federal Vaccines for Children Program. 
The bill creates the Maine 
Vaccine Board to determine the ~osts of purchasing and administering the vaccines and 
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directs the board to assess these costs to appropriate health insurers in the State based on 
each insurer's share of nonelderly insureds in the State.