§2332-J. Coverage for contraceptives
1. Coverage requirements. All individual and group nonprofit hospital and medical services plan policies and contracts and all nonprofit health care plan policies and contracts that provide coverage for prescription drugs or outpatient medical services must provide coverage for all prescription contraceptives approved by the federal Food and Drug Administration or for outpatient contraceptive services, respectively, to the same extent that coverage is provided for other prescription drugs or outpatient medical services. For purposes of this section, the term "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of contraceptive methods to prevent an unintended pregnancy. This section may not be construed to apply to prescription drugs or devices that are designed to terminate a pregnancy.
[PL 1999, c. 341, §1 (NEW); PL 1999, c. 341, §5 (AFF).]
2. Exclusion for religious employer. A religious employer may request and a nonprofit hospital or medical service organization or nonprofit health care service organization shall grant an exclusion under the policy or contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion under this subsection shall provide prospective insureds and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing a nonprofit hospital or medical service organization or nonprofit health care service organization to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes or for prescription contraception that is necessary to preserve the life or health of a covered person. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 United States Code, Section 3121 (w) (3) (A) and that qualifies as a tax-exempt organization under 26 United States Code, Section 501(c) (3).
[PL 1999, c. 341, §1 (NEW); PL 1999, c. 341, §5 (AFF).]
3. 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.
[PL 2003, c. 517, Pt. B, §7 (NEW).]
4. Coverage of contraceptive supplies. Coverage required under this section must include coverage for contraceptive supplies in accordance with the following requirements. For purposes of this section, "contraceptive supplies" means all contraceptive drugs, devices and products approved by the federal Food and Drug Administration to prevent an unwanted pregnancy.
A. Coverage must be provided without any deductible, coinsurance, copayment or other cost-sharing requirement. [PL 2021, c. 609, §1 (NEW).]
B. If the federal Food and Drug Administration has approved one or more therapeutic equivalents of a contraceptive supply, an insurer is not required to cover all those therapeutically equivalent versions in accordance with this subsection, as long as at least one is covered without any deductible, coinsurance, copayment or other cost-sharing requirement in accordance with this subsection. [PL 2021, c. 609, §1 (NEW).]
C. Coverage must be provided for the furnishing or dispensing of prescribed contraceptive supplies intended to last for a 12-month period, which may be furnished or dispensed all at once or over the course of the 12 months at the discretion of the health care provider. [PL 2021, c. 609, §1 (NEW).]
[PL 2021, c. 609, §1 (NEW).]
Revisor's Note: §2332-J. Coverage for services of certified nurse practitioners; certified nurse midwives (As enacted by PL 1999, c. 396, §1 and affected by §7 is REALLOCATED TO TITLE 24, SECTION 2332-K)
Revisor's Note: §2332-J. Coverage for services provided by registered nurse first assistants (As enacted by PL 1999, c. 412, §1 is REALLOCATED TO TITLE 24, SECTION 2332-L)
SECTION HISTORY
RR 1999, c. 1, §§30,31 (RAL). PL 1999, c. 341, §1 (NEW). PL 1999, c. 341, §5 (AFF). PL 1999, c. 396, §1 (NEW). PL 1999, c. 396, §7 (AFF). PL 1999, c. 412, §1 (NEW). PL 2003, c. 517, §B7 (AMD). PL 2021, c. 609, §1 (AMD).
Structure Maine Revised Statutes
Chapter 19: NONPROFIT HOSPITAL OR MEDICAL SERVICE ORGANIZATIONS
Subchapter 1: GENERAL PROVISIONS
24 §2301-A. Continuity of licensure; business combinations
24 §2302-A. Utilization review data
24 §2302-B. Penalty for failure to notify of hospitalization
24 §2302-C. Penalty for noncompliance with utilization review programs
24 §2303. Mental health services
24 §2303-A. Dentist included in definition of physician (REPEALED)
24 §2303-B. Optional coverage for chiropractic services (REPEALED)
24 §2303-C. Coverage for chiropractic services (REPEALED)
24 §2305-A. Conditions of certificate of authority
24 §2307-B. Loss information (REPEALED)
24 §2308. Investments (REPEALED)
24 §2308-A. Health insurance affiliates
24 §2313. Licenses; fees (REPEALED)
24 §2314. Suspension or revocation of certificate of authority
24 §2316. Certificates or contracts; approval by superintendent
24 §2317. Other provisions applicable
24 §2317-A. Explanation and notice to parent of minor (REPEALED)
24 §2317-B. Applicability of provisions
24 §2318. Maternity benefits and dependent coverage
24 §2318-A. Maternity and routine newborn care
24 §2319. Newborn children coverage
24 §2319-A. Mandated offer of domestic partner benefits
24 §2320. Home health care coverage
24 §2320-A. Screening mammograms
24 §2320-B. Acupuncture services
24 §2320-C. Coverage for breast cancer treatment
24 §2320-D. Medical food coverage for inborn error of metabolism
24 §2320-E. Coverage for Pap tests
24 §2320-F. Off-label use of prescription drugs for cancer
24 §2320-G. Off-label use of prescription drugs for HIV or AIDS
24 §2321. Rate filings on individual subscriber and membership contracts
24 §2321-A. Standards for when filings are inadequate
24 §2321-B. Appropriate level of subscriber reserves
24 §2324. Certified ambulatory health care center outpatient coverage
24 §2325. Community health services coverage (REPEALED)
24 §2325-A. Mental health services coverage
24 §2325-B. Mandated Benefits Advisory Commission (REPEALED)
24 §2325-C. Coverage for prostate cancer screening
24 §2326. Appeals from order or decision of the superintendent
24 §2327-A. Applicability (REPEALED)
24 §2327-B. Rating practices in individual insurance (REPEALED)
24 §2327-C. Continuity of health insurance coverage (REPEALED)
24 §2329. Equitable health care for substance use disorder treatment
24 §2330. Conversion on termination of contracts or eligibility (REPEALED)
24 §2331. Optional coverage for optometric services
24 §2332-A. Coordination of benefits
24 §2332-B. Acquired Immune Deficiency Syndrome
24 §2332-C. Assessment of mandated benefits proposals (REPEALED)
24 §2332-E. Standardized claim forms
24 §2332-F. Coverage for diabetes supplies
24 §2332-G. Gynecological and obstetrical services (REALLOCATED FROM TITLE 24, SECTION 2332-F)
24 §2332-H. Assignment of benefits
24 §2332-I. Effective date of cancellation
24 §2332-J. Coverage for contraceptives
24 §2332-M. Coverage for general anesthesia for dentistry
24 §2332-N. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery