An Act to Support an Insured Patient's Access to Affordable Health Care with Timely Access to Health Care Prices
Maine Legislature, Session 131, LD 1740
Committee: Health and Human Services
Sponsors: ARFORD, BAILEY, BELL, CYRWAY, DODGE, MADIGAN, PERRY, SHAGOURY, WILLIAMS, BRAKEY
Amends: 22 MRSA §1718-B, 22 MRSA §1718-C, 24 MRSA §2905, 24-A MRSA §4303

Legislative Document
No. 1740
H.P. 1119
House of Representatives, April 20, 2023
An Act to Support an Insured Patient's Access to Affordable Health 
Care with Timely Access to Health Care Prices
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative ARFORD of Brunswick.
Cosponsored by Senator BAILEY of York and
Representatives: BELL of Yarmouth, CYRWAY of Albion, DODGE of Belfast, MADIGAN 
of Waterville, PERRY of Calais, SHAGOURY of Hallowell, WILLIAMS of Bar Harbor, 
Senator: BRAKEY of Androscoggin.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1718-B, sub-§2, ¶B, as enacted by PL 2013, c. 515, §2, is 
amended to read:
B.  A  By posting a notice on prominent display to patients, a health care entity shall 
inform patients about the availability of prices for the most frequently provided health 
care services and procedures and the ability of a patient to request a good faith estimate 
of the price of medical services pursuant to section 1718-C.
Sec. 2.  22 MRSA §1718-C, as enacted by PL 2013, c. 560, §2, is repealed and the 
following enacted in its place:
§1718-C.  Estimate of total price of single medical encounter for patient
1.  Uninsured patient.  Upon the request of an uninsured patient, a health care entity, 
as defined in section 1718-B, subsection 1, paragraph B, shall provide within a reasonable 
time of the request a good faith estimate of the total price of medical services to be rendered 
directly by that health care entity during a single medical encounter. If the health care entity 
is unable to provide an accurate estimate of the total price of a specific medical service 
because the amount of the medical service to be consumed during the medical encounter is 
unknown in advance, the health care entity shall provide a brief description of the basis for 
determining the total price of that particular medical service. If a single medical encounter 
will involve medical services to be rendered by one or more 3rd-party health care entities, 
the health care entity shall identify each 3rd-party health care entity to enable the uninsured 
patient to seek an estimate of the total price of medical services to be rendered directly by 
each health care entity to that patient. When providing an estimate as required by this 
subsection, a health care entity shall also notify the uninsured patient of any charity care 
policy adopted by the health care entity and the availability of public or private health care 
coverage.
2.  Insured patient.  Upon the request of an insured patient, a health care entity, as 
defined in section 1718-B, subsection 1, paragraph B, shall provide within 3 business days 
of the request a good faith estimate of the allowed amount under that patient's insurance 
coverage to be paid by an insurer for the medical services to be rendered directly by that 
health care entity during a single medical encounter. If a single medical encounter will 
involve medical services to be rendered by one or more 3rd-party health care entities, the 
health care entity shall identify each 3rd-party health care entity to enable the patient to 
seek an estimate of the allowed amount for medical services to be rendered directly by each 
health care entity to that patient. When providing the information required by this 
subsection, a health care entity shall also notify the insured patient of any charity care 
policy adopted by the health care entity and the availability of other public or private health 
insurance coverage. A health care entity shall provide the good faith estimate requested by 
the patient to the patient and to the patient's health insurance carrier.
Sec. 3.  24 MRSA §2905, sub-§4 is enacted to read:
4.  Notice of right to request information about price of medical services.  Any 
written document provided by a health care entity, as defined in Title 22, section 1718-B, 
subsection 1, paragraph B, to a patient prior to rendering health care treatment for the 
purpose of obtaining informed consent to that treatment must include a notice of the 
patient's right to request a good faith estimate of the price of medical services pursuant to 
Title 22, section 1718-C.
Sec. 4.  24-A MRSA §4303, sub-§13-A is enacted to read:
13-A.  Advanced explanation of benefits.  Upon receipt of a good faith estimate 
provided to the enrollee by a health care entity in accordance with Title 22, section 1718-C, 
subsection 2, a carrier shall provide within 3 business days of the request an advanced 
explanation of benefits in clear and understandable language that complies with the federal 
No Surprises Act, Public Law 116-260, and its implementing regulations.
SUMMARY
Under current law, health care entities are required to provide an estimate of the total 
price of medical services to be rendered directly by that health care entity during a single 
medical encounter within a reasonable time of a request from an uninsured patient. This 
bill requires health care entities to provide a good faith estimate of the allowed amount 
under an insured patient's health insurance coverage to be paid by an insurer for the medical 
services to be rendered directly by that health care entity during a single medical encounter. 
This bill requires the information to be provided within 3 business days of a request from 
an insured patient to the patient and to the patient's health insurance carrier. This bill also 
requires health care entities to post notice of a patient's right to request this information in 
their offices and include such notice in a patient's written consent to treatment form that 
must be signed prior to receiving health care treatment or services. The bill requires health 
insurance carriers to provide an insured patient with an advanced explanation of benefits 
within 3 business days of receiving a good faith estimate from a health care entity for 
medical services.