An Act To Require Estimates of Patient Costs Prior to Treatment
Maine Legislature, Session 126, LD 0755
Committee: Health and Human Services
Sponsors: BOLAND, GRATWICK, DeCHANT, PEAVEY HASKELL, RUSSELL, SHAW, STUCKEY, COLLINS, SAVIELLO
Amends: 22 MRSA §1725

Legislative Document 
No. 755 
H.P. 506 
House of Representatives, February 28, 2013 
An Act To Require Estimates of Patient Costs Prior to Treatment 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative BOLAND of Sanford. 
Cosponsored by Senator GRATWICK of Penobscot and 
Representatives: DeCHANT of Bath, MacDONALD of Old Orchard Beach, PEAVEY 
HASKELL of Milford, RUSSELL of Portland, SHAW of Standish, STUCKEY of Portland, 
Senators: COLLINS of York, SAVIELLO of Franklin. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §1725 is enacted to read: 
§1725.  Cost estimates of care 
1.  Provision of written cost estimate.  A health care provider shall provide a patient 
with a written cost estimate of a proposed health care procedure or course of 
nonemergency treatment, including prescription medication, recommended for the patient 
and the amount of that cost that will be covered by the patient's insurer or other 3rd-party 
payor.  A cost estimate required by this section must include the provider's reasons for 
recommending the specific procedure or course of treatment and, if there are other 
options for the procedure or course of  treatment, inform the patient of those options and 
costs of those options.  If a health care provider reports to a referring health care provider 
recommending a procedure or course of treatment for a referred patient, the reporting 
health care provider shall provide the referring health care provider a cost estimate 
pursuant to the provisions of this section.  For purposes of this subsection, "health care 
provider" means a physician, health care practitioner, hospital, clinic, clinical laboratory, 
health care facility or other person or facility that provides health care services and is 
licensed or registered by the State. 
2.  Person receiving the records.  The written cost estimate required in subsection 1 
must be released to: 
A.  The person who is the subject of the treatment if that person is 18 years of age or 
older; 
B.  The parent, guardian ad litem or legal guardian of the person who is the subject of 
the treatment if the person is a minor or if a legal guardian is appointed; 
C.  The designee of a durable health care power of attorney executed by the person 
who is the subject of treatment at the time that the power of attorney is in effect; or 
D.  The agent, guardian or surrogate pursuant to the Uniform Health-care Decisions 
Act. 
SUMMARY 
This bill requires a health care provider to provide to a person recommended for a 
nonemergency health care procedure or course of treatment a cost estimate of the 
procedure or treatment,  the provider's reasons for the procedure or treatment, other 
options and their costs and the amount of the cost that will be paid for by the person's 
insurer.  This bill also requires a health care provider to provide a cost estimate to a 
referring provider on a recommended procedure or course of treatment for a referred 
patient.