An Act To Allow Certified Registered Nurse Anesthetists To Bill for Their Services
Maine Legislature, Session 129, LD 1434
Committee: Health Coverage, Insurance and Financial Services
Sponsors: PERRY, MOORE, MEYER
Amends: 24 MRSA §2332-K, 24-A MRSA §2757, 24-A MRSA §2847-H, 24-A MRSA §4248

Legislative Document
No. 1434
H.P. 1044
House of Representatives, March 28, 2019
An Act To Allow Certified Registered Nurse Anesthetists To Bill for 
Their Services
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative PERRY of Calais.
Cosponsored by Senator MOORE of Washington and
Representative: MEYER of Eliot.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24 MRSA §2332-K, as amended by PL 2003, c. 517, Pt. B, §8, is further 
amended to read:
§2332-K.  Coverage for services of certified nurse practitioners; certified nurse 
midwives; certified registered nurse anesthetists 
1.  Required coverage for services upon referral of primary care provider.  A 
nonprofit hospital or a medical service organization that issues individual and group 
health care contracts shall provide coverage under those contracts for services performed 
by a certified nurse practitioner or, certified nurse midwife or certified registered nurse 
anesthetist to a patient who is referred to the certified nurse practitioner or, certified nurse 
midwife or certified registered nurse anesthetist by a primary care provider when those 
services are within the lawful scope of practice of the certified nurse practitioner or, 
certified nurse midwife or certified registered nurse anesthetist.
2.  Required coverage for self-referred services.  With respect to individual and 
group health care contracts that do not require the selection of a primary care provider, a 
nonprofit hospital or medical service organization shall provide coverage under those 
contracts for services performed by a certified nurse practitioner or, certified nurse 
midwife or certified registered nurse anesthetist when those services are covered services 
and when they are within the lawful scope of practice of the certified nurse practitioner 
or, certified nurse midwife or certified registered nurse anesthetist.
3.  Limits; coinsurance; deductibles.  Any contract that provides coverage for 
services under this section may contain provisions for maximum benefits and coinsurance 
and reasonable limitations, deductibles and exclusions to the extent that these provisions 
are not inconsistent with the requirements of this section.
4.  Application.  The requirements of this section apply to all policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State. 
For purposes of this section, all contracts are deemed to be renewed no later than the next 
yearly anniversary of the contract date.
Sec. 2.  24-A MRSA §2757, as reallocated by RR 1999, c. 1, §32, is amended to 
read:
§2757.  Coverage for services of certified nurse practitioners; certified nurse 
midwives; certified registered nurse anesthetists
1.  Required coverage for services upon referral of primary care provider.  An 
insurer that issues individual health insurance policies and contracts shall provide 
coverage under those contracts for services performed by a certified nurse practitioner or, 
certified nurse midwife or certified registered nurse anesthetist to a patient who is 
referred to the certified nurse practitioner or, certified nurse midwife or certified 
registered nurse anesthetist by a primary care provider when those services are within the 
lawful scope of practice of the certified nurse practitioner or, certified nurse midwife or 
certified registered nurse anesthetist.
2.  Required coverage for self-referred services.  With respect to individual health 
insurance policies and contracts that do not require the selection of a primary care 
provider, an insurer shall provide coverage under those contracts for services performed 
by a certified nurse practitioner or, certified nurse midwife or certified registered nurse 
anesthetist when those services are covered services and when they are within the lawful 
scope of practice of the certified nurse practitioner or, certified nurse midwife or certified 
registered nurse anesthetist.
3.  Limits; coinsurance; deductibles.  Any contract that provides coverage for 
services under this section may contain provisions for maximum benefits and coinsurance 
and reasonable limitations, deductibles and exclusions to the extent that these provisions 
are not inconsistent with the requirements of this section.
Sec. 3.  24-A MRSA §2847-H, as amended by PL 2003, c. 517, Pt. B, §19, is 
further amended to read:
§2847-H.  Coverage for services of certified nurse practitioners; certified nurse 
midwives; certified registered nurse anesthetists
1.  Required coverage for services upon referral of primary care provider.  An 
insurer that issues group health insurance policies and contracts shall provide coverage 
under those contracts for services performed by a certified nurse practitioner or, certified 
nurse midwife or certified registered nurse anesthetist to a patient who is referred to the 
certified nurse practitioner or, certified nurse midwife or certified registered nurse 
anesthetist by a primary care provider when those services are within the lawful scope of 
practice of the certified nurse practitioner or, certified nurse midwife or certified 
registered nurse anesthetist.
2.  Required coverage for self-referred services.  With respect to group health 
insurance policies and contracts that do not require the selection of a primary care 
provider, an insurer shall provide coverage under those contracts for services performed 
by a certified nurse practitioner or, certified nurse midwife or certified registered nurse 
anesthetist when those services are covered services and when they are within the lawful 
scope of practice of the certified nurse practitioner or, certified nurse midwife or certified 
registered nurse anesthetist.
3.  Limits; coinsurance; deductibles.  Any contract that provides coverage for 
services under this section may contain provisions for maximum benefits and coinsurance 
and reasonable limitations, deductibles and exclusions to the extent that these provisions 
are not inconsistent with the requirements of this section.
4.  Application.  The requirements of this section apply to all group policies, 
contracts and certificates executed, delivered, issued for delivery, continued or renewed 
in this State. For purposes of this section, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date.
Sec. 4.  24-A MRSA §4248, as amended by PL 2003, c. 517, Pt. B, §28, is further 
amended to read:
§4248.  Coverage for services of certified nurse practitioners; certified nurse 
midwives; certified registered nurse anesthetists
1.  Required coverage for services upon referral of primary care provider. A 
health maintenance organization that issues individual and group health care contracts  
shall provide coverage under those contracts for services performed by a participating 
certified nurse practitioner or, participating certified nurse midwife or participating 
certified registered nurse anesthetist to a patient who is referred to the participating 
certified nurse practitioner or, participating certified nurse midwife or participating 
certified registered nurse anesthetist by a primary care provider when those services are 
within the lawful scope of practice of the participating certified nurse practitioner or, 
participating certified nurse midwife or participating certified registered nurse anesthetist.
2.  Required coverage for self-referred services.  With respect to individual and 
group health care contracts that do not require the selection of a primary care provider, a 
health maintenance organization shall provide coverage under those contracts for services 
performed by a participating certified nurse practitioner or, participating certified nurse 
midwife or participating certified registered nurse anesthetist when those services are 
covered services and when they are within the lawful scope of practice of the 
participating certified nurse practitioner or, participating certified nurse midwife or 
participating certified registered nurse anesthetist.
3.  Limits; coinsurance; deductibles.  Any contract that provides coverage for 
services under this section may contain provisions for maximum benefits and coinsurance 
and reasonable limitations, deductibles and exclusions to the extent that these provisions 
are not inconsistent with the requirements of this section.
4.  Application.  The requirements of this section apply to all individual and group 
policies, contracts and certificates executed, delivered, issued for delivery, continued or 
renewed in this State. For purposes of this section, all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date.
Sec. 5.  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, 2020.  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 insurers, health maintenance organizations and nonprofit hospitals 
or medical service organizations to provide coverage for the services of certified 
registered nurse anesthetists provided to individuals.