An Act To
Maine Legislature, Session 128, LD 1237
Committee Amendment CA_A_H179 (House)
Amends: 24-A MRSA §2756, 24-A MRSA §2847-G, 24-A MRSA §4247

COMMITTEE AMENDMENT "4" to H.P. 860, L.D. 
Require Insurance Coverage for Contraceptive Supplies" 
1237, Bill, "An Act To 
Amend the bill by striking out eve1ything after the enacting clause and before the 
summaiy and inserting the following: 
'Sec. 1. 24-A MRSA §2756, sub-§3 is enacted to read: 
3. Coverage of contraceptive supplies. Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following 
requirements. 
For purposes of this section, "contraceptive supplies" means all 
contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy. 
A. Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement for at least one contraceptive supply within each 
method of contraception that is identified by the federal Food and Drug 
Administration to prevent an unwanted pregnancy and prescribed by a health care 
provider. 
B. 
If there is a therapeutic equivalent of a contraceptive supply within a 
contraceptive method approved by the federal Food and Drug Administration, an 
insurer may provide coverage for more than one contraceptive supply and may 
impose cost-sharing requirements as long as at least one contraceptive supply within 
that method is available without cost sharing. 
C. If an individual's health care provider recommends a particular contraceptive 
supply approved by the federal Food and Drug Administration for the individual 
based on a determination of medical necessity, the insurer shall defer to the provider's 
determination and judgment and shall provide coverage without cost sharing for the 
prescribed contraceptive supply. 
D. 
Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be 
COMMITTEE AMENDMENT 
COMMIITEE AMENDMENT "H" to H.P. 860, L.D. 1237 
furnished or dispensed all at once or over the course of the 12 months at the 
discretion of the health care provider. 
Sec. 2. 24-A MRSA §2847-G, sub-§4 is enacted to read: 
4. Coverage of contraceptive supplies. Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following 
requirements. 
For purposes of this section, "contraceptive supplies" means all 
contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy. 
A. Coverage must be provided without any deductible, coinsurance, copayment or 
O 
other cost-sharing requirement for at least one contraceptive supply within each 
method of contraception that is identified by the federal Food and Drug 
Administration to prevent an unwanted pregnancy and prescribed by a health care 
provider. 
B. 
If there is a therapeutic equivalent of a contraceptive supply within a 
contraceptive method approved by the federal Food and Drug Administration, an 
insurer may provide coverage for more than one contraceptive supply and may 
impose cost-sharing requirements as long as at least one contraceptive supply within 
that method is available without cost sharing. 
C. If an individual's health care provider recommends a particular contraceptive 
supply approved by the federal Food and Drug Administration for the individual 
based on a detennination of medical necessity, the insurer shall defer to the provider's 
determination and judgment and shall provide coverage without cost sharing for the 
prescribed contraceptive supply. 
D. 
Coverage must be provided for the furnishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be 
furnished or dispensed all at once or over the course of the 12 months at the 
discretion of the health care provider. 
Sec. 3. 24-A MRSA §4247, sub-§4 is enacted to read: 
4. Coverage of contraceptive supplies. Coverage required under this section must 
include coverage for contraceptive supplies in accordance with the following 
requirements. 
For purposes of this section, "contraceptive supplies" means all 
contraceptive drugs, devices and products approved by the federal Food and Drug 
Administration to prevent an unwanted pregnancy. 
A. Coverage must be provided without any deductible, coinsurance, copayment or 
other cost-sharing requirement for at least one contraceptive supply within each 
method of contraception that is identified by the federal Food and Drug 
Administration to prevent an unwanted pregnancy and prescribed by a health care 
provider. 
B. 
If there is a therapeutic equivalent of a contraceptive supply within a 
contraceptive method approved by the federal Food and Drug Administration, a 
health maintenance organization may provide coverage for more than one 
contraceptive supply and may impose cost-sharing requirements as long as at least 
one contraceptive supply within that method is available without cost sharing, 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "R "to H.P. 860, L.D. 1237 
C. If an individual's health care provider recommends a particular contraceptive 
supply approved by the federal Food and Drug Administration for the individual 
based on a determination of medical necessity, the health maintenance organization 
shall defer to the provider's determination and judgment and shall provide coverage 
without cost sharing for the prescribed contraceptive supply. 
D. 
Coverage must be provided for the fumishing or dispensing of prescribed 
contraceptive supplies intended to last for a 12-month period, which may be 
fumished or dispensed all at once or over the course of the 12 months at the 
discretion of the health care 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, 2019. For purposes of this Act, all contracts are deemed to be 
renewed no later than the next yearly atmiversary of the contract date. 
Sec. 5. Exemption from review. Notwithstanding the Maine Revised Statutes, 
Title 24-A, section 2752, this Act is enacted without review and evaluation by the Bureau 
of Insurance within the Department of Professional and Financial Regulation.' 
SUMMARY 
This amendment is the majority report of the committee and replaces the bill. It 
amends the requirements in current law relating to coverage of contraceptives to include 
coverage for contraceptive supplies without cost sharing for at least one drug, device or 
other product for each contraceptive method. If a health care provider recommends a 
particular contraceptive supply on the basis of medical necessity, coverage must be 
provided for that patiicular supply without cost sharing. The amendment also clarifies 
that coverage must be provided for contraceptives dispensed for a 12-month period at the 
discretion of the health care provider. 
The requirements apply to all individual and group policies and contracts issued or 
renewed on or after January 1, 2019. The amendment also adds language exempting the 
bill from the provisions of the Maine Revised Statutes, Title 24-A, section 2752. 
FISCAL NOTE REQUIRED 
0 
(See attached) 
COMMITTEE AMENDMENT 
Fiscal Detail and Notes 
Approved: 05/03/17 :Wac.. 
LD 1237 
LR 1832(02) 
An Act To Require Insurance Coverage for Contraceptive Supplies 
Fiscal Note for Bill as Amended by Committee Amendment·~· (ff ,, /-7 0 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor cost increase - Highway Fund 
Any additional costs to the Department of Administrative and Financial Services, Division of Employee Health & 
Benefits, to implement the provisions of this bill are expected to be minor and can be absorbed within existing 
budgeted resources. 
LR1832(02) - Fiscal Note - Page 1 of 1