An Act To Require Health Insurers To Provide Coverage for Human Leukocyte Antigen Testing To Establish Bone Marrow Donor Transplantation Suitability
Maine Legislature, Session 126, LD 1600
Committee Amendment CA_B_H756 (House)

COMMITTEE AMENDMENT ,]3, to H.P. 1172, L.D. 1600, Bill, "An Act To 
Require Health Insurers To Provide Coverage for Human Leukocyte Antigen Testing To 
Establish Bone Marrow Donor Transplantation Suitability" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 24-A MRS A §4320-1 is enacted to read: 
§4320-1. Coverage for the cost of testing for bone marrow donation suitability 
1. Required coverage. A carrier offering a health plan in this State shall provide 
coverage for laboratory fees up to $150 arising from human leukocyte antigen testing 
performed to establish bone marrow transplantation suitability in accordance with the 
following requirements: 
A. The enrollee covered under the health plan must meet the criteria for testing 
established by the National Marrow Donor Program, or its successor organization; 
B. 
The testing must be performed in a facility that is accredited by a national 
accrediting body with requirements that are substantially equivalent to or more 
stringent than those of the College of American Pathologists and is certified under the 
federal Clinical Laboratories Improvement Act of 1967, 42 United States Code, 
Section 263a; 
C. 
At the time of the testing, the enrollee covered under the health plan must 
complete and sign an informed consent form that authorizes the results of the test to 
be used for participation in the National Marrow Donor Program, or its successor 
organization, and acknowledges a willingness to be a bone marrow donor if a suitable 
match is found; 
D. The carrier may limit each enrollee to one test per lifetime; and 
E. The carrier may limit the scope of coverage to an enrollee who is an immediate 
family member of an individual for whom a bone marrow transplant has been 
determined medically necessary or who becomes a donor as part of a donor drive 
COMMITTEE AMENDMENT 
.~ . 
. ~. 
COMMITTEE AMENDMEN~" to H.P. 1172, L.D. 1600 
conducted on behalf of an individual for whom a bone marrow transplant has been 
determined medically necessary. 
2. 
Prohibition on cost-sharing. 
A carrier may not impose any deductible, 
copayment, coinsurance or other cost-sharing requirement on an enrollee for the coverage 
required under this section. 
Sec. 2. Application. The requirements of this Act apply to all policies, contracts 
and certificates subject to this Act that are executed, delivered, issued for delivery, 
continued or renewed in this State on or after January 1, 2015. 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 amendment is a minority report of the committee and replaces the bill. This 
amendment requires carriers offering health plans in this State to provide coverage for 
laboratory fees up to $150 arising from human leukocyte antigen testing performed to 
establish bone marrow transplantation suitability and prohibits carriers from imposing 
any cost-sharing requirement on enrollees for the test. The amendment specifies that 
enrollees in a health plan must meet the criteria for testing established by the National 
Marrow Donor Program and sign an infonned consent form at the time of testing along 
with an acknowledgment that the enrollee is willing to be a donor if a suitable match is 
found. Testing is limited to once per lifetime. Unlike the majority report, this amendment 
limits the scope of coverage to immediate family members and donor drives conducted 
for a specified individual donee. 
The amendment applies to all health plan policies and contracts issued or renewed on 
or after January 1,2015. 
FISCAL NOTE REQURh) 
(See Attached) 
COMMITTEE AMENDMENT 
\ 
Approved: 03/25/14 ;:b/ac 
LD 1600 
LR 2402(03) 
An Act To Require Health Insurers To Provide Coverage for Human Leukocyte Antigen Testing To 
Fiscal Detail and Notes 
Establish Bone Marrow Donor Transplantation Suitability 
Fiscal Note for Bill as Amended by Committee Amendment 13 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Potential future biennium cost increase - General Fund 
0-+ -750J 
Any additional costs to the State Employee Health Insurance Program are expected to be minor and can be absorbed 
within existing budgeted resources. The Patient Protection and Affordable Care Act (ACA) requires States to defray 
the cost of mandated benefits not included in the ACA's Essential Health Benefits. The Bureau of Insurance's report 
on LD 1600 to the Joint Standing Committee on Insurance and Financial Services estimated the cost of increased 
coverage due to LD 1600 to be approximately $48,000 per year. The specifics of this required State payment under 
the ACA to defray the costs of this mandate (i.e., how much, what program(s) and when) cannot be determined at this 
time. 
LR2402(03) - Fiscal Note - Page 1 of 1