An Act To Promote Patient Choice and Access to Health Care
Maine Legislature, Session 127, LD 0978
Committee Amendment CA_A_H118 (House)
Amends: 24-A MRSA §2748, 24-A MRSA §2840-A, 24-A MRSA §4236

COMMITTEE AMENDMENT "A" to H.P. 675, L.D. 978, Bill, "An Act To 
Promote Patient Choice and Access to Health Care" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 24-A MRSA §2748, sub-§5 is enacted to read: 
5. Reimbursement; discrimination. An insurer subject to this section may not 
refuse to reimburse a chiropractic provider who participates in the insurer's provider 
network for providing a health care service or procedure covered by the insurer as long as 
the chiropractic provider is acting within the lawful scope of that provider's license in the 
delivery of the covered service or procedure. Consistent with reasonable medical 
management techniques specified under the insurer's contract with respect to the method. 
treatment or setting for a covered service or procedure. the insurer may not discriminate 
based on the chiropractic provider's license. This subsection does not require an insurer to 
accept all chiropractic providers into a network or govern the amount of the 
reimbursement paid to a chiropractic provider. 
Sec. 2. 24-A MRSA §2840-A, sub-§5 is enacted to read: 
5. Reimbursement; discrimination. An insurer subject to this section may not 
refuse to reimburse a chiropractic provider who participates in the insurer's provider 
network for providing a health care service or procedure covered by the insurer as long as 
the chiropractic provider is acting within the lawful scope of that provider's license in the 
delivery of the covered service or procedure. Consistent with reasonable medical 
management techniques specified under the insurer's contract with respect to the method. 
treatment or setting for a covered service or procedure. the insurer may not discriminate 
based on the chiropractic provider's license. This subsection does not require an insurer to 
accq>t all chiropractic providers into a network or govern the amount of the 
reimbursement paid to a chiropractic provider. 
Sec. 3. 24-A MRSA §4236, sub-§2, as enacted by PL 1993, c. 669, §6, is 
amended to read: 
COMMITTEE AMENDMENT 
COMMITIEE AMENDMENT 'A" to H.P. 675, L.D. 978 
2. Benefits; discrimination. The health maintenance organization shall provide 
benefits covering care by chiropractic providers at least equal to and consistent with the 
benefits paid to other health care providers treating similar neuro-musculoskeletal 
conditions. 
A health maintenance organization may not refuse to reimburse a 
chiropractic provider who participates in the health maintenance organization's provider 
network for providing a health care service or procedure covered by the health 
maintenance organization as long as the chiropractic provider is acting within the lawful 
scope of that provider's license in the delivery of the covered service or procedure. 
Consistent with reasonable medical management techniques specified under the health 
maintenance organization's contract with respect to the method. treatment or setting for a 
covered service or procedure. the health maintenance organization may not discriminate 
based on the chiropractic provider's license. This subsection does not require a health 
maintenance organization to accept all chiropractic providers into a network or govern the 
reimbursement paid to a chiropractic provider. 
Sec. 4. Application. The requirements of this Act apply to all policies, contracts 
and certificates executed, delivered, issued for delivery, continued or renewed in this 
State on or after January 1,2016. 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 replaces the bill. The amendment prohibits health insurance carriers 
offering individual and group health plans from refusing to reimburse for services 
provided by a chiropractor acting within the scope of the chiropractor's license if the 
services are covered by the carrier and the chiropractor participates in the carrier's 
provider network. The amendment applies to all policies and contracts issued or renewed 
on or after January 1,2016. 
COMMITTEE AMENDMENT