An Act To Provide Access to Opioid Analgesics with Abuse-deterrent Properties
Maine Legislature, Session 127, LD 0919
Committee: Insurance and Financial Services
Sponsors: HOBBINS, GIDEON, KATZ, VOLK
Amends: 24-A MRSA §4320-J

Legislative Document 
No. 919 
H.P. 638 
House of Representatives, March 17, 2015 
An Act To Provide Access to Opioid Analgesics with Abuse-
deterrent Properties 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
ROBERT B. HUNT 
Clerk 
Presented by Representative HOBBINS of Saco. 
Cosponsored by Representative: GIDEON of Freeport, Senators: KATZ of Kennebec, VOLK 
of Cumberland. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24-A MRSA §4320-J is enacted to read: 
§4320-J.  Coverage for abuse-deterrent opioid analgesic drug products  
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A.  "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid 
analgesic drug product approved by the federal Food and Drug Administration with 
abuse-deterrent labeling claims that indicate the drug product is expected to result in 
a meaningful reduction in abuse. 
B.  "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or 
other out-of-pocket expense associated with a health plan. 
C.  "Opioid analgesic drug product" means a drug product in the opioid analgesic 
drug class prescribed to treat moderate to severe pain or other conditions, whether in 
immediate release or extended release, long-acting form and whether or not 
combined with other drug substances to form a single drug product or dosage form. 
2.  Required coverage.  A carrier offering a health plan in this State shall provide 
coverage for abuse-deterrent opioid analgesic drug products as preferred drugs on any 
formulary, preferred drug list or other list of drugs used by the carrier. Any cost sharing 
imposed by a carrier for coverage of abuse-deterrent opioid analgesic drug products may 
not exceed the lowest cost-sharing level applied to other prescription drugs. An increase 
in enrollee cost sharing or other disincentives for prescribers or dispensers to achieve 
compliance with this section may not be implemented.  
3.  Utilization management. The following requirements apply. 
A.  Any prior authorization requirements or other utilization review measures for 
opioid analgesic drug products on the market and any denials of coverage made 
pursuant to those measures may not require use of opioid analgesic drug products 
first in order to obtain abuse-deterrent opioid analgesic drug products. 
B.  This section may not be construed to prevent a carrier from applying prior 
authorization requirements to abuse-deterrent opioid analgesic drug products as long 
as such requirements are applied to opioid analgesic drug products in the same 
manner. 
Sec. 2.  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 bill requires all health insurance carriers offering individual and group health 
plans to provide coverage for abuse-deterrent opioid analgesic drug products as preferred 
drugs on any formulary, preferred drug list or other list of drugs used by the carrier. The 
bill applies to all policies and contracts issued or renewed on or after January 1, 2016.