An Act to Promote the Use of Free Annual Wellness Visits by Ensuring Proper Medical Billing
Maine Legislature, Session 131, LD 0637
Committee Amendment CA_A_H70 (House)
Amends: 22 MRSA §1718-H, 24-A MRSA §4303

COMMITTEE AMENDMENT" If,, to H.P. 414, L.D. 637, "An Act to Promote the 
Use of Free Annual Wellness Visits by Ensuring Proper Medical Billing" 
Amend the bill by striking out the title and substituting the following: 
'An Act to Promote the Use of Free Annual Wellness Visits by Ensuring Proper 
Disclosure' 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 22 MRSA §1718-H is enacted to read: 
§1718-H. Disclosure related to annual wellness visit 
A health care entity, as defined in section 1718-B. subsection 1, paragraph B, at the 
time of an annual wellness visit by an insured patient, shall disclose to the patient that not 
all services provided during the course of an annual wellness visit may be covered as 
preventive services without any out-of-pocket costs to the patient by the patient's health 
plan, as defined in Title 24-A, section 4301-A, subsection 7. and that. if the patient has 
questions about the scope of covered services under the patient's health plan, the patient 
should contact the patient's health insurance carrier. 
Sec. 2. 24-A MRSA §4303, sub-§15, as enacted by PL 2011, c. 364, §26, is 
amended to read: 
15. Uniform explanation of coverage documents and standardized definitions. A 
carrier offering a health plan in this State shall: 
A. Provide to applicants, enrollees and policyholders or certificate holders a summary 
of benefits and an explanation of coverage that accurately describe the benefits and 
coverage under the applicable plan or coverage. A summary of benefits and an 
explanation of coverage must conform with the requirements of the federal Affordable 
Care Act; aoo 
COMMITTEE AMENDMENT 
ROS 
COMMITTEE AMENDMENT•.//.• to H.P. 414, L.D. 637 
B. 
Use standard definitions of insurance-related and medical-related terms in 
connection with health insurance coverage as required by the federal Affordable Care 
Act-;; and 
C. Provide notice to enrollees and policyholders or certificate holders that preventive 
services are covered without cost sharing as provided in section 4320-A, subsection 1, 
but services related to a specific health concern, condition or injury may be separately 
billed as an office visit and may be subject to cost-sharing requirements as provided in 
the health plan. 
Sec. 3. Application. That section of this Act that amends the Maine Revised 
Statutes, Title 24-A, section 4303, subsection 15 applies to all policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State on 
or after January 1, 2024. For purposes of this Act, all policies, contracts and certificates 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 is the majority report of the committee and replaces the bill. The 
amendment requires health care providers and health insurance caniers to provide notice 
about services included in annual wellness visits and that some services petformed during 
a wellness visit and services related to a specific health condition may have an out-of-
pocket cost. The requirements for health insurance carriers apply beginning January 1, 
2024. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04/10/23 ;:/YaC-
LD 637 
LR 1584(02) 
An Act to Promote the Use of Free Annual Wellness Visits by Ensuring Proper Medical Billing 
Fiscal Note for Bill as Amended by Committee Amendment ./J. {J/-1D) 
Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - All Funds 
Fiscal Detail and Notes 
Requiring health insurance plans to provide notice to members regarding cost sharing for preventive and other 
services that may be included in an annual wellness visit is expected to increase costs to the State Employee Health 
Plan by minor amounts that can be absorbed within existing budgeted resources. 
LR1584(02) - Fiscal Note - Page 1 of 1