An Act To Facilitate Access to the MaineCare Family Planning Benefit
Maine Legislature, Session 129, LD 0078
Committee: Health and Human Services
Sponsors: McCREIGHT, SANBORN, BERRY, HANDY, HYMANSON, KORNFIELD, SCHNECK, TEPLER, TIPPING, FOLEY
Amends: 22 MRSA §3173-G

Legislative Document
No. 78
H.P. 64
House of Representatives, January 15, 2019
An Act To Facilitate Access to the MaineCare Family Planning 
Benefit
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative McCREIGHT of Harpswell.
Cosponsored by Senator SANBORN, H. of Cumberland and
Representatives: BERRY of Bowdoinham, HANDY of Lewiston, HYMANSON of York, 
KORNFIELD of Bangor, SCHNECK of Bangor, TEPLER of Topsham, TIPPING of Orono, 
Senator: FOLEY of York.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §3173-G, as enacted by PL 2015, c. 356, §1 and affected by §4, 
is repealed and the following enacted in its place:
§3173-G.  Medicaid coverage for reproductive health care and family planning 
services
1.  Family planning benefit.  The department shall provide for the delivery of 
federally approved Medicaid services to a qualified adult or adolescent whose individual 
income is equal to or below 209% of the nonfarm income official poverty line for 
reproductive health care and family planning services, as described in 42 United States 
Code, Section 1396d(a)(4)(C), including pregnancy prevention, testing and treatment for 
sexually transmitted infection or cancer and access to contraception, in accordance with 
the federal Patient Protection and Affordable Care Act, Public Law 111-148, as amended 
by the federal Health Care and Education Reconciliation Act of 2010, Public Law 111-
152.
2.  Presumptive eligibility.  If a MaineCare provider determines that an adult or 
adolescent is likely to be eligible for services under this section, the provider must be 
reimbursed for services provided under this section until the department determines that 
the adult or adolescent is not eligible.
3.  Automatic review of eligibility and enrollment.  If an individual applying for 
MaineCare eligibility under section 3174-G, subsection 1, paragraph A, C, D, E, F, G or 
H is determined ineligible under those paragraphs, the department shall make a 
determination of eligibility under this section and shall enroll an individual who is 
eligible for services under this section.  The department shall automatically review an 
individual's eligibility for services under this section when an individual loses eligibility 
under section 3174-G, subsection 1, paragraph A due to the birth of a child or an increase 
in income and shall enroll an individual who is eligible under this section for services.
4.  Single application.  The department shall use a single application form for adults 
and adolescents applying for MaineCare eligibility under this section and for adults 
applying for MaineCare eligibility under section 3174-G, subsection 1, paragraph H.
5.  Rules.  The department shall adopt routine technical rules as defined by Title 5, 
chapter 375, subchapter 2-A to carry out the provisions of this section.
SUMMARY
This bill establishes presumptive eligibility for individuals who are likely to qualify 
for the family planning benefit under the Maine Revised Statutes, Title 22, section 
3173-G and requires the Department of Health and Human Services to provide for 
presumptive eligibility.  It requires the department to automatically review an individual's 
eligibility for the family planning benefit if, upon application, the individual is found 
ineligible under Title 22, section 3174-G, subsection 1, paragraph A, C, D, E, F, G or H 
and to enroll the individual if found eligible for the family planning benefit.  It requires 
the department to automatically review an individual's eligibility for the family planning 
benefit after an individual loses eligibility for the MaineCare pregnancy benefit under 
Title 22, section 3174-G, subsection 1, paragraph A due to the birth of a child or an 
increase in income and to enroll the individual, if found eligible, for the family planning 
benefit. It also requires the department to use a single application form for individuals 
applying for eligibility for the family planning benefit under Title 22, section 3173-G and 
under the adult expansion provisions under Title 22, section 3174-G, subsection 1, 
paragraph H. The bill directs the Department of Health and Human Services to adopt 
rules to carry out these requirements.