An Act to Protect Health Care for Rural and Underserved Areas by
Maine Legislature, Session 132, LD 1018
Sponsors: BAILEY, MORRIS, DAUGHTRY

Legislative Document
No. 1018
S.P. 435
In Senate, March 13, 2025
An Act to Protect Health Care for Rural and Underserved Areas by 
Prohibiting Discrimination by Participants in a Federal Drug 
Discount Program
Received by the Secretary of the Senate on March 12, 2025.  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 BAILEY of York.
Cosponsored by Representative MORRIS of Turner and
Senators: BALDACCI of Penobscot, President DAUGHTRY of Cumberland, MOORE of 
Washington, Representatives: DUCHARME of Madison, FREDERICKS of Sanford, 
MASTRACCIO of Sanford, MATHIESON of Kittery, NUTTING of Oakland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA c. 101 is enacted to read:
CHAPTER 101
PROTECT HEALTH CARE FOR RURAL AND UNDERSERVED 
COMMUNITIES ACT
§7701. Short title
This chapter may be known and cited as "the Protect Health Care for Rural and 
Underserved Communities Act."
§7702. Definitions
As used in this chapter, unless the context otherwise indicates, the following terms 
have the following meanings.
1.  Health insurance issuer. "Health insurance issuer" has the same meaning as 
"carrier" as defined in section 4301-A, subsection 3.
2. Manufacturer. "Manufacturer" has the same meaning as in Title 32, section 
13702-A, subsection 19.
3. Pharmacy. "Pharmacy" has the same meaning as in Title 32, section 13702-A, 
subsection 24. 
4. Pharmacy benefits manager. "Pharmacy benefits manager" has the same meaning 
as in section 4347, subsection 17.
5. 340B contract pharmacy. "340B contract pharmacy" means a pharmacy that has a 
contract with a 340B entity to receive and dispense 340B drugs to the 340B entity's patients 
on behalf of the 340B entity. For the purposes of this chapter, a record of a current 340B 
contract pharmacy relationship between the 340B entity and the 340B contract pharmacy 
that is on the 340B United States Department of Health and Human Services, Health 
Resources and Services Administration, Office of Pharmacy Affairs 340B Information 
System website, or such publicly accessible successor website maintained by the United 
States Department of Health and Human Services, is prima facie evidence of such a 
contract.
6. 340B drug. "340B drug" means a drug that is purchased or eligible for purchase 
under Section 340B of the federal Public Health Service Act, 42 United States Code, 
Section 256b(a)(3).
7. 340B entity.  "340B entity" means an entity participating or authorized to participate 
in the federal 340B drug discount program, as described in 42 United States Code, Section 
256b, including its pharmacy, or any pharmacy contracted with the participating entity to 
dispense drugs purchased through the federal 340B drug discount program.
§7703. Prohibition of certain discriminatory actions by manufacturer or agent related 
to 340B entities 
1. Interference with acquisition or delivery of 340B drugs prohibited. A 
manufacturer or its agent may not deny, restrict, prohibit or otherwise interfere with, either 
directly or indirectly, the acquisition of a 340B drug by, or delivery of a 340B drug to, a 
340B contract pharmacy on behalf of a 340B entity unless receipt of that 340B drug is 
prohibited by the United States Department of Health and Human Services.
2. Submission of claims or utilization data prohibited. A manufacturer or its agent 
may not, either directly or indirectly, require a 340B entity to submit any claims or 
utilization data as a condition for allowing the acquisition of a 340B drug by, or delivery 
of a 340B drug to, a 340B entity unless the claims or utilization data sharing is required by 
the United States Department of Health and Human Services.
3. Other interference prohibited. A manufacturer or distributor may not otherwise 
interfere with a 340B entity unless expressly authorized by the United States Department 
of Health and Human Services.
§7704. Prohibition of certain discriminatory actions with respect to reimbursement 
of 340B entities
With respect to reimbursement of a 340B entity for 340B drugs, a health insurance 
issuer, pharmacy benefits manager or other 3rd-party payor or agent may not:
1. Reimbursement at lower rate prohibited. Reimburse a 340B entity for 340B drugs 
at a rate lower than that paid for the same drug to entities that are not 340B entities or lower 
the reimbursement amount for a claim on the basis that the claim is for a 340B drug;
2. Imposition of different terms and conditions prohibited. Impose any terms or 
conditions on any 340B entity that differ from such terms or conditions applied to entities 
that are not 340B entities or pharmacies that are not 340B contract pharmacies including, 
without limitation:
A. Fees, charges, clawbacks or other adjustments or assessments. For purposes of this 
paragraph, "other adjustment or assessment" includes, without limitation, placing any 
additional requirements, restrictions or burdens upon the 340B entity that result in 
administrative costs or fees to the 340B entity that are not placed upon entities that are 
not 340B entities, including affiliate pharmacies of the health insurance issuer, 
pharmacy benefits manager or other 3rd-party payor;
B. Dispensing fees that are less than the dispensing fees for entities that are not 340B 
entities or pharmacies that are not 340B contract pharmacies;
C. Restrictions or requirements regarding participation in standard or preferred 
pharmacy networks;
D. Requirements relating to inventory management systems or to the frequency or 
scope of audits;
E. Requirements that a claim for a drug include any identification, billing modifier, 
attestation or other indication that a drug is a 340B drug in order to be processed or 
submitted or reimbursed unless it is required by the United States Department of Health 
and Human Services, Centers for Medicare and Medicaid Services or the Department 
of Health and Human Services for the administration of the MaineCare program; or
F. Any other restrictions, conditions, practices or policies that are not imposed on 
entities that are not 340B entities;
3. Reversal, resubmission or clarification of claims prohibited. Require a 340B 
entity to reverse, resubmit or clarify a claim after the initial adjudication unless these 
actions are in the normal course of pharmacy business and are not related to 340B drug 
pricing; 
4. Discrimination against 340B entity that interferes with patient choice. 
Discriminate against a 340B entity in a manner that prevents or interferes with a patient's 
choice to receive 340B drugs from the 340B entity, including the administration of the 
drugs. For purposes of this subsection, it is considered a discriminatory practice that 
prevents or interferes with a patient's choice to receive drugs at a 340B entity if a health 
insurance issuer, pharmacy benefits manager or other 3rd-party payor places any additional 
requirements, restrictions or burdens upon the 340B entity that result in administrative costs 
or fees to the 340B entity, including but not limited to requiring a claim for a drug to include 
any identification, billing modifier, attestation or other indication that a drug is a 340B drug 
in order to be processed or resubmitted unless it is required by the United States Department 
of Health and Human Services, Centers for Medicare and Medicaid Services or the 
Department of Health and Human Services for the administration of the MaineCare 
program; 
5. Discrimination against 340B entity that interferes with patient choice of 
delivery method. Include any other provision in a contract between a health insurance 
issuer, pharmacy benefits manager or other 3rd-party payor and a 340B entity that 
discriminates against the 340B entity that participates in the 340B program or prevents or 
interferes with a patient's choice to receive a 340B drug from a 340B entity, whether by 
direct administration, in-person dispensing, direct delivery, mail or other form of shipment;
6. Restrictions or additional charges prohibited. Place a restriction or additional 
charge on a patient who chooses to receive 340B drugs from a 340B entity; 
7. Submission of data pertaining to ingredient costs or pricing of 340B drugs 
prohibited. Require or compel the submission of ingredient costs or pricing data pertaining 
to 340B drugs from a 340B entity to any health insurance issuer, pharmacy benefits 
manager or other 3rd-party payor; or 
8. Exclusion from pharmacy network prohibited. Exclude any 340B entity from the 
health insurance issuer, pharmacy benefits manager or other 3rd-party payor network on 
the basis that the 340B entity dispenses 340B drugs or refuse to contract with a 340B entity 
for reasons other than those that apply equally to entities that are not 340B entities. 
§7705.  MaineCare program not affected 
This chapter does not apply to the MaineCare program as a payor when the MaineCare 
program provides reimbursement for covered outpatient drugs as defined in 42 United 
States Code, Section 1396r–8(k)(2).
§7706. Enforcement
1. Enforcement; violation. A violation of this chapter is subject to enforcement under 
the Maine Unfair Trade Practices Act, including any of the remedies provided for in that 
Act.  A violation is committed each time a prohibited act under this chapter occurs.
2. Civil action authorized. A 340B entity may bring a civil action in the Superior 
Court against a person who violates this chapter. 
3. Exemption from enforcement. The limited distribution of a drug required under 21 
United States Code, Section 355–1 is not a violation of this chapter. 
§7707. Federal preemption; statutory construction 
1. No less restrictive than federal law. This chapter may not be construed or applied 
to be less restrictive than federal law for a person or entity regulated by this chapter.
2. No conflict with federal law and regulation or other laws of this State. This 
chapter may not be construed or applied in any manner that conflicts with:
A. Applicable federal law and related regulations; or
B. Other laws of this State if the State law is compatible with applicable federal law.
SUMMARY
This bill prevents discrimination by pharmaceutical manufacturers, health insurance 
carriers, pharmacy benefits managers and their agents against pharmacies and health care 
providers that participate in the federal prescription drug discount program, known as the 
340B drug discount program. The bill's provisions do not apply to the MaineCare program. 
The bill also includes language to clarify that the provisions may not be construed or 
applied in any way that conflicts with federal law.