An Act Regarding Prescription Medications for Children under the MaineCare Program
Maine Legislature, Session 126, LD 0716
Committee: Health and Human Services
Sponsors: MALABY, MAKER, TURNER, BURNS
Amends: 22 MRSA §3174-W

Legislative Document 
No. 716 
H.P. 488 
House of Representatives, February 26, 2013 
An Act Regarding Prescription Medications for Children under the 
MaineCare Program 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative MALABY of Hancock. 
Cosponsored by Representatives: MAKER of Calais, TURNER of Burlington, Senator: 
BURNS of Washington. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §3174-WW is enacted to read: 
§3174-WW.  Program regarding prescription medications for children 
The department shall adopt a program regarding prescription medications for children 
that consists of a prescription medication protocol, prescription medication monitoring 
and prior authorization for reimbursement under the MaineCare program. The program 
must ensure that children have access to medically needed prescription medications in 
compliance with the requirements of this section and the United States Department of 
Health and Human Services, Centers for Medicare and Medicaid Services. 
1.  Stimulant drugs.  The program must include coverage for medications classified 
as stimulants in accordance with the prescribing guidelines for various age ranges 
established by the American Academy of Pediatrics and must include, but not be limited 
to, training for caregivers in behavioral therapy in order to increase the effectiveness of 
treatment.  The program must include monitoring to ensure that children who are 
prescribed stimulants have been properly diagnosed and are monitored on an ongoing 
basis for effectiveness and side effects and to determine whether adjustments are required 
to maintain the balance between the benefits and side effects of the stimulants. 
2.  Stimulant drugs and benzodiazepine drugs.  The program must include a 
protocol to ensure that children who are prescribed a stimulant drug and a benzodiazepine 
drug concurrently are reviewed and monitored on an ongoing basis for appropriateness 
and effectiveness of the combined drugs.  The protocol must include the provision of 
educational materials to parents and caregivers that cover appropriateness of use, 
potential side effects, ongoing monitoring to determine effectiveness, necessity of 
managing behavior and the effectiveness of combining behavioral therapy with 
medication.  The protocol must include a prior authorization process for continued 
concurrent use beyond 3 months.  Prior authorization must be based on clinically valid 
studies justifying the concurrent use of the drugs for the diagnosis of the child and the 
applicable time period. 
SUMMARY 
This bill directs the Department of Health and Human Services to adopt a program 
regarding prescription medications for children that consists of a prescription medication 
protocol, monitoring and prior authorization for reimbursement under the MaineCare 
program. The program must ensure that children have access to medically needed 
prescription medications in compliance with the requirements of this bill and the United 
States Department of Health and Human Services, Centers for Medicare and Medicaid 
Services.