An Act To Require Private Insurance Coverage for Certain Services for Children with Disabilities
Maine Legislature, Session 124, LD 0425
Committee: Insurance and Financial Services
Sponsors: CONNOR, BRANNIGAN, EATON, FLEMINGS, HUNT, LEGG, MILLER, PERRY, TREAT
Amends: 24 MRSA §2317-B, 24-A MRSA §2765, 241-A MRSA §28417-Q, 24-A MRSA §4257

FIRST REGULAR SESSIOr~-2009 
Legislative Document 
No. 425 
H.P.313 
House of Representatives, Febmary 10,2009 
An Act To Require Private Insurance Coverage for Certain Services 
for Children with Disabilities 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative CONNOR of Kennebunk. 
Cosponsored by Senator BRANNIGAN of Cumberland and 
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MILLICENT M. MacFARLAND 
Clerk 
Representatives: EATON of Sullivan, FLEMINGS of Bar Harbor, HUNT of Buxton, LEGG of 
Kennebunk, MILLER of Somerville, PERRY of Calais, TREAT of Hallowell. 
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Be it enacted by the People ofthe State of Maine as follows: 
Sec. 1. 24 MRSA §2317-B, sub-§12-E is enacted to read: 
12-E. Title 24-A, sections 2765, 2847-0 and 4257. Coverage for children's early 
intervention services, Title 24-A, sections 2765, 2847-0 and 4257; 
Sec. 2. 24-A MRSA §2765 is enacted to read: 
§2765. Coverage for children's early intervention services 
1. Definition. For purposes of this section, "children's early intervention services" 
means services provided by licensed occupational therapists, physical therapists, speech-
language pathologists ordinical social workers working with children from birth to 36 
months of age with an identified developmental disability or delay as described in the 
federal Individuals with Disabilities Education Act, Part C, 20 United States Code, 
Section 1411, et seq. 
2. 
Required coverage. All individual health insurance policies, contracts and 
certificates must provide coverage for children's early intervention services in accordance 
with this subsection. 
A. A referral from the child's primary care provider is required. 
B. The policy, contract or certificate may limit coverage to $3,200 per year for each 
child not to exceed $9,600 by the child's 3rd birthday. 
C. The policy, contract or certificate may contain provisions for maximum benefits 
and coinsurance and reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements of this section. 
Sec. 3. 241-A MRSA §28417-Q is enacted to read: 
§2847-0. Coverage for children's early intervention services 
1. Definition. For purposes of this section, "children's early intervention services" 
means services provided by licensed occupational therapists, physical therapists, speech-
language pathologists or clinical social workers working with children from birth to 36 
months of age with an identified developmental disability or delay as described in the 
federal Individuals with Disabilities Education Act, Part C, 20 United States Code, 
Section 1411, et seq. 
2. 
Required coverage. 
All· group health insurance policies, contracts and 
certificates must provide coverage for children's early intervention services in accordance 
with this subsection. . 
A. A referral from the child's primary care provider is required. 
B. The policy, contract or certificate may limit coverage to $3,200 per year for each 
child not to exceed $9,600 by the child's 3rd birthday. 
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C. The policy, contract or certificate may contain provisions for maximum benefits 
and coinsurance and reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements of this section. 
Sec. 4. 24-A MRSA §4257 is enacted to read: 
§4257. Coverage for children's early intervention services 
1. Definition. For purposes of this section, "children's early intervention services" 
means services provided by licensed occupational therapists, physical therapists, speech-
language pathologists or clinical social workers working with children from birth to 36 
months of age with an identified developmental disability or delay as described in the 
federal Individuals with Disabilities Education Act, Part C, 20 United States Code, 
Section 1411, et seq. 
2. Required coverage. All individual and group health maintenance organization 
policies, contracts and certificates must provide coverage for children's early intervention 
services in accordance with this subsection. 
A. A referral from the child's primary care provider is required. 
B. The policy, contract or certificate may limit coverage to $3,200 per year for each 
child not to exceed $9,600 by the child's 3rd birthday. 
C. The policy, contract or certificate may contain provisions for maximum benefits 
and coinsurance and reasonable limitations, deductibles and exclusions to the extent 
that these provisions are not inconsistent with the requirements of this section. 
Sec. 5. Application. This Act applies to health insurance policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State on 
or after January 1, 2010. For purposes of this Act, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
SUMMARY 
This bill requires individual and group health insurance policies and health 
maintenance organization contracts to provide coverage for children's early intervention 
services after a referral from a primary care provider for children from birth to 3 years of 
age if the child has an identified developmental disability or delay as described in the 
federal Individuals with Disabilities Education Act, Part C. The bill limits coverage to 
$3,200 per year per child up to a maximum of $9,600 by the child's 3rd birthday. The bill 
applies to all policies, contracts and certificates issued or renewed on or after January 1, 
2010.