An Act Relating to Orally Administered Cancer Therapy
Maine Legislature, Session 126, LD 0627
Committee Amendment CA_A_S160 (Senate)
Committee: Insurance and Financial Services

COMMITTEE AMENDMENT "A " to S.P. 217, L.D. 627, Bill, "An Act Relating 
to Orally Administered Cancer Therapy" 
Amend the bill by striking out the title and substituting the following: 
'Resolve, Directing a Review of Strategies To Improve the Affordability and 
Accessibility of Oral Chemotberapy Treatment' 
Amend the bill by striking out everything after the title and before the summary and 
inserting the following: 
'Sec. 1. Review and report. Resolved: That the Department of Professional and 
Financial Regulation, Bureau of Insurance and the Department of Health and Hwnan 
Services, Maine Center for Disease Control and Prevention, referred to in this section as 
"the conveners," shall jointly convene a work group of stakeholders to review and report 
on insurance coverage as it relates to the affordability and accessibility of chemotherapy 
treatment in the State, including coverage disparities between orally administered, 
intravenously administered and injected chemotherapy. The conveners shall invite 
stakeholders to participate in the work group, including, but not limited to, oncologists, 
cancer patients and a hospital cancer center; representatives of the Maine Medical 
Association, American Cancer Society Cancer Action Network, Susan G. Komen Maine 
and Maine Cancer Consortium; 2 representatives of health insurance carriers; and the 
Joint Standing Committee on Insurance and Financial Services. The work group shall 
convene no later than October 1, 2013. The conveners shall facilitate the duties of the 
work group required by this resolve within existing resources and may rely on the 
expertise and resources of work group members to fulfill the duties described in this 
resolve; and be it further 
Sec. 2. Duties. Resolved: That the duties of the work group under section 1 
include, but are not limited to, the following: 
1. 
Reviewing the federal laws and regulations pertaining to health insurance 
coverage for chemotherapy administered orally, intravenously and by injection, including 
the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended 
COMMITTEE AMENDMENT 
~ • roo 
COMMITTEE AMENDMENT ';4 "to S.P. 217, L.D. 627 
by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-
152, and the regulations pertaining to essential health benefits under that Act; 
2. Reviewing studies from this State and other states regarding the affordability and 
accessibility of oral chemotherapy, as well as cost and actuarial analyses of coverage 
parity for oral chemotherapy; 
3. 
Reviewing any available state data on insurance coverage for chemotherapy 
treatment administered orally, intravenously and by injection, including patient out-of-
pocket costs and drug formularies; 
4. Identifying the advantages and disadvantages of requiring coverage for prescribed, 
orally administered oral chemotherapy that is equivalent to the coverage provided for 
intravenously administered or injected oral chemotherapy; and 
5. 
Making recommendations regarding requiring coverage for prescribed, orally 
administered oral chemotherapy; and be it further 
Sec. 3. Report. Resolved: 
That, by December 1, 2013, the Department of 
Professional and Financial Regulation, Bureau of Insurance, after consultation with the 
Department of Health and Human Services, Maine Center for Disease Control and 
Prevention and work group members, shall submit a written report on behalf of the work 
group with the findings and any recommendations resulting from the review under 
section 1 to the Joint Standing Committee on Insurance and Financial Services. The joint 
standing committee may report out a bill during the Second Regular Session of the 126th 
Legislature relating to the report; and be it further 
Sec. 4. 
Appropriations and allocations. 
Resolved: 
That the following 
appropriations and allocations are made. 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Insurance - Bureau of 0092 
Initiative: Allocates funds for the costs of contractual services to convene the work group 
and review and report on fmdings. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
SUMMARY 
2013-14 
$10,000 
$10,000 
2014-15 
$0 
$0 
This amendment replaces the bill with a resolve. The amendment directs the 
Department of Professional and Financial Regulation, Bureau of Insurance and the 
Department of Health and Human Services, Maine Center for Disease Control and 
Prevention to jointly convene a work group to review and report on insurance coverage as 
it relates to the affordability and accessibility of chemotherapy treatment in Maine. The 
amendment requires the Bureau of Insurance, after consultation with the Maine Center 
for Disease Control and Prevention and work group members, to submit a written report 
COMMITTEE AMENDMENT 
~~·6. 
COMMITTEE AMENDMENT 'A, "to S.P. 217, L.D. 627 
on behalf of the work group by December 1, 2013 to the Joint Standing Committee on 
Insurance and Financial Services and authorizes the committee to report out a bill based 
on the report. The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: OS/28/13 
;t!d'ac:.. 
LD627 
LR 1498(02) 
An Act Relating to Orally Administered Cancer Therapy 
Fiscal Note for Bill as Amended by Committee Amendment 1{' IS -1 00) 
Committee: Insurance and Financial Services 
L 
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Appropriations/Allocations 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2013-14 
FY 2014-15 
$10,000 
$0 
Projections 
FY 2015-16 
$0 
Projections 
FY 2016-17 
$0 
Provides a one-time Other Special Revenue Funds allocation of $10,000 in 2013-14 for the Bureau of Insurance in the 
Department of Professional and Financial Regulation for contractual services to convene the work group and review 
and report on findings. Other costs for the bureau and for the Department of Health and Human Services are expected 
to be minor and can be absorbed within existing budgeted resources. 
LR1498(02) - Fiscal Note - Page 1 of 1