An Act To Require Insurance Coverage for Certified Midwife Services
Maine Legislature, Session 130, LD 0600
Committee: Health Coverage, Insurance and Financial Services
Sponsors: BRENNER, BREEN, GRAMLICH, LIBBY
Amends: 24 MRSA §2332-K, 24-A MRSA §2757, 24-A MRSA §2847-H, 24-A MRSA §4248, 24-A MRSA §4303

Legislative Document
No. 600
S.P. 239
In Senate, March 1, 2021
An Act To Require Insurance Coverage for Certified Midwife 
Services
Received by the Secretary of the Senate on February 25, 2021.  Referred to the Committee 
on Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered 
printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BRENNER of Cumberland.
Cosponsored by Senator: BREEN of Cumberland, Representatives: GRAMLICH of Old 
Orchard Beach, LIBBY of Auburn.
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 midwives; 
certified nurse midwives
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, certified midwife or certified nurse midwife to a patient who is 
referred to the certified nurse practitioner, certified midwife or certified nurse midwife by 
a primary care provider when those services are within the lawful scope of practice of the 
certified nurse practitioner, certified midwife or certified nurse midwife.
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, certified midwife or 
certified nurse midwife when those services are covered services and when they are within 
the lawful scope of practice of the certified nurse practitioner, certified midwife or certified 
nurse midwife.
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 midwives; 
certified nurse midwives
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, certified 
midwife or certified nurse midwife to a patient who is referred to the certified nurse 
practitioner, certified midwife or certified nurse midwife by a primary care provider when 
those services are within the lawful scope of practice of the certified nurse practitioner, 
certified midwife or certified nurse midwife.
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, certified midwife or certified nurse midwife when those services are 
covered services and when they are within the lawful scope of practice of the certified nurse 
practitioner, certified midwife or certified nurse midwife.
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 midwives; 
certified nurse midwives
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, certified 
midwife or certified nurse midwife to a patient who is referred to the certified nurse 
practitioner, certified midwife or certified nurse midwife by a primary care provider when 
those services are within the lawful scope of practice of the certified nurse practitioner, 
certified midwife or certified nurse midwife.
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, certified midwife or certified nurse midwife when those services are 
covered services and when they are within the lawful scope of practice of the certified nurse 
practitioner, certified midwife or certified nurse midwife.
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 midwives; 
certified nurse midwives
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, participating certified midwife or participating certified nurse 
midwife to a patient who is referred to the participating certified nurse practitioner, 
participating certified midwife or participating certified nurse midwife by a primary care 
provider when those services are within the lawful scope of practice of the participating 
certified nurse practitioner, participating certified midwife or participating certified nurse 
midwife.
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, participating certified midwife or 
participating certified nurse midwife when those services are covered services and when 
they are within the lawful scope of practice of the participating certified nurse practitioner, 
participating certified midwife or participating certified nurse midwife.
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.  24-A MRSA §4303, sub-§5, as amended by PL 2007, c. 199, Pt. B, §10, is 
further amended to read:
5.  Identification of services provided by certified nurse practitioners, certified 
midwives and certified nurse midwives.  All claims for coverage of services provided by 
certified nurse practitioners, certified midwives and certified nurse midwives must identify 
the certified nurse practitioners, certified midwives and certified nurse midwives who 
provided those services.  A carrier offering or renewing a health plan in this State shall 
assign identification numbers or codes to certified nurse practitioners, certified midwives 
and certified nurse midwives who provide covered services for enrollees covered under 
that plan.  A claim submitted for payment to a carrier by a health care provider or facility 
must include the identification number or code of the certified nurse practitioner, certified 
midwife or certified nurse midwife who provided the service and may not be submitted 
using the identification number or code of a physician or other health care provider who 
did not provide the covered service.
Sec. 6.  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 October 1, 2021.  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 insurance coverage for services performed by certified midwives.