An Act To Promote Better Dental Care for Cancer Survivors
Maine Legislature, Session 130, LD 0665
Committee Amendment CA_A_H864 (House)
Amends: 24-A MRSA §4320-R

COMMITTEE AMENDMENT "I{,' to H.P. 492, L.D. 665, "An Act To Promote 
Better Dental Care for Cancer Survivors" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 24-A MRSA §4320-R is enacted to read: 
§4320-R. Coverage for dental services for cancer patients 
1. Reguired coverage. Except as provided in subsection 2, a carrier offering a health 
plan in this State shall provide coverage for medically necessary dental procedures in 
accordance with the following for an enrollee who has been diagnosed with cancer. 
A. Coverage must be provided for fluoride treatment and dental procedures that are 
medically necessary to reduce the risk of infection or eliminate infectiori or to treat 
tooth loss or decay in an enrollee prior to beginning cancer treatment, including 
chemotherapy, biological therapy or radiation therapy treatment. 
B. Coverage must be provided for dental procedures that are medically necessary to 
reduce the risk of infection or eliminate infection or to treat tooth loss or decay that are 
the direct or indirect result of cancer treatment, including chemotherapy, biological 
therapy or radiation therapy treatment. 
• 
C. Coverage required under this subsection must include coverage for laboratory 
assessments, medications and treatments. 
2. Routine preventive dental care not required. A carrier is not required to provide 
coverage for routine preventive dental care, including cleaning and sealants. 
Sec. 2. 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 1803l(d)(3)(B) because the requirements clarify that health 
insurance carriers must cover medically necessary dental procedures prior to beginning 
COMMITTEE AMENDMENT 
•iJ."• ~2 
u_, 01-' ,_, 
\-•-
COMMITTEE AMENDMENT .. ;9-,, to H.P. 492, L.D. 665 
cancer treatment and that are the direct or indirect result of cancer treatment under the law 
in effect prior to the effective date of this Act. 
Sec, 3. 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, 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 requires a health plan to include 
coverage for dental procedures that are medically necessary to reduce the risk of infection 
or eliminate infection or to treat tooth loss or decay in an enrollee prior to beginning cancer 
treatment or that are the direct or indirect result of cancer treatment. The requirements 
apply to all health plans issued or renewed on or after January 1, 2023. 
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 
( 
et Cost (Savings) 
General Fund 
Highway Fund 
Approved: 03/24/22 fr,a(!!. 
LD665 
LR493(02) 
An Act To Promote Better Dental Care for Cancer Survivors 
Fiscal Note for Bill as Amended by Committee Amendment ,4--{f!-?J& l{) 
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 
$28,516 
$10,039 
Projections 
FY 2024-25 
$29,942 
$10,541 
Appropriations/ Allocations 
General Fund 
$0 
$0 
$0 
$0 
$28,516 
$10,039 
$29,942 
$10,541 
Highway Fund 
Fiscal Detail and Notes 
Requiring health plans to include coverage for medically necessary dental procedures for enrollees diagnosed with 
cancer will increase General Fund costs to the State Employee Health Plan beginning in the plan year that starts July 
1, 2023 by $28,516 in fiscal year 2023-24. The bill will also increase Highway Fund costs by $10,039 beginning in 
fiscal year 2023-24. These estimates are based on the assumption that this required coverage will increase costs to the 
plan by $0.23 per member per month (PMPM). 
LR0493(02) - Fiscal Note - Page 1 of 1