An Act To Require Private Insurance Coverage for Postpartum Care
Maine Legislature, Session 130, LD 1357
Committee Amendment CA_A_S470 (Senate)
Amends: 24-A MRSA §2743-B, 24-A MRSA §2834-D, 24-A MRSA §4234-F

COMMITTEE AMENDMENT " A " to S.P. 443, L.D. 1357, "An Act To Require 
Private Insurance Coverage for Postpartum Care" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Clarify Health Insurance Coverage for Postpartum Care' 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 24-A MRSA §2743-B is enacted to read: 
§2743-B. Maternity and postpartum care 
An insurer that issues individual contracts providing maternity benefits shall provide 
coverage for 12 months following childbirth for postpartum care services and support 
necessary to transition a . patient to a healthy and stable condition that meets the 
recommendations of the American College of Obstetricians and Gynecologists outlined in 
the "Optimizing Postpartum Care" opinion published May 2018. The postpartum care 
services and support provided in accordance with this section must include coverage for 
development of a postpartum care plan; contact with the patient within 3 weeks of the end 
of pregnancy; a comprehensive postpartum visit, including a full assessment of the patient's 
physical, social and psychological well-being; treatment of complications of pregnancy and 
childbirth, including pelvic floor disorders and postpartum depression; assessment of risk 
factors for cardiovascular disease; and care related to pregnancy loss. 
Sec. 2. 24-A MRSA §2834-D is enacted to read: 
§2834-D. Maternity and postpartum care 
An insurer that issues group contracts providing maternity benefits shall provide 
coverage for 12 months following childbirth for postpartum care services and support 
necessary to transition a patient to a healthy and stable condition that meets the 
recommendations of the American College of Obstetricians and Gynecologists outlined in 
the "Optimizing Postpartum Care" opinion published May 2018. The postpartum care 
services and support provided in accordance with this section must include coverage for 
Page l - 130LR0888(02) 
COMMITTEE AMENDMENT 
?,..OS 
COMMITTEE AMENDMENT" fl "to S.P. 443, L.D. 1357 { 5-L(7 OJ 
development of a postpartum care plan; contact with the patient within 3 weeks of the end 
of pregnancy; a comprehensive postpartum visit, including a full assessment of the patient's 
physical, social and psychological well-being; treatment of complications of pregnancy and 
childbirth, including pelvic floor disorders and postpartum depression; assessment of risk 
factors for cardiovascular disease; and care related to pregnancy loss. 
Sec. 3. 24-A MRSA §4234-F is enacted to read: 
§4234-F. Maternity and postpartum care 
A health maintenance organization that issues individual and group contracts providing 
maternity benefits shall provide coverage for 12 months following childbirth for 
postpartum care services and support necessary to transition a patient to a healthy and stable 
condition that meets the recommendations of the American College of Obstetricians and 
Gynecologists outlined in the "Optimizing Postpartum Care" opinion published May 2018. 
The postpartum care services and support provided in accordance with this section must 
include coverage for development of a postpartum care plan; contact with the patient within 
weeks of the end of pregnancy; a comprehensive postpartum visit, including a full 
assessment of the patient's physical, social and psychological well-being; treatment of 
complications of pregnancy and childbirth, including pelvic floor disorders and postpartum 
depression; assessment of risk factors for cardiovascular disease: and care related to 
pregnancy loss. 
Sec. 4. No addition to State's essential health benefits; legislative finding. 
The Legislature finds that the requirements of this Act do not constitute an addition to the 
State's essential health benefits that requires defrayal of costs by the State pursuant to 42 
United States Code, Section 18031 ( d)(3 )(B) because the requirements clarify that existing 
law mandating coverage for maternity benefits includes coverage for 12 months of 
postpartum care that meets the recommendations of the American College of Obstetricians 
and Gynecologists. 
Sec. 5. Application. This Act applies to all policies, contracts and certificates 
executed, delivered, issued for delivery, continued or renewed in this State on or after 
January 1, 2023. For purposes of this Act, all contracts are deemed to be renewed no later 
than the next yearly anniversary of the contract date.' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment replaces the bill. The amendment clarifies that maternity benefits 
provided by health insurers must include coverage for 12 months of postpartum care that 
meets the recommendations of the American College of Obstetricians and Gynecologists. 
The amendment makes the provisions apply to both individual and group contracts issued 
by insurers and health maintenance organizations and changes the application date to 
January 1, 2023. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" /J "to S.P. 443, L.D. 1357 L 5 -l/ l Q) 
The amendment also includes language stating the Legislature's finding that the 
changes are not an addition to the State's essential health benefits that would require the 
State to defray costs pursuant to the federal Patient Protection and Affordable Care Act. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Net Cost (Savings) 
General Fund 
Highway Fund 
Approved: 03/24/22 feae 
LD 1357 
LR888(02) 
An Act To Require Private Insurance Coverage for Postpartum Care 
Fiscal Note for Bill as Amended by Committee Amendment 'tt' CS- c17 S) 
Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Future biennium cost increase - All Funds 
FY 2021-22 
FY 2022-23 
$0 
$0 
$0 
$0 
Projections 
FY 2023-24 
$177,298 
$62,415 
Projections 
FY2024-25 
$186,lvJ 
$65,536 
Appropriations/ Allocations 
General Fund 
$0 
$0 
$0 
$0 
$177,298 
$62,415 
$186,163 
$65,536 
Highway Fund 
Fiscal Detail and Notes 
Requiring health insurers that cover maternity benefits to provide coverage for 12 months of postpartum care that 
meets the recommendations of the American College of Obstetricians and Gynecologists will increase General Fund 
costs to the State Employee Health Plan beginning in the plan year that starts July 1, 2023 by $177,298 in fiscal year 
2023-24. The bill will also increase Highway Fund costs by $62,415 beginning in fiscal year 2023-24. These estimates 
are based on the assumption that this required coverage will increase costs to the plan by $1.43 per member per month 
(PMPM). 
LR0888(02) - Fiscal Note - Page I of 1