Maine Revised Statutes
Subchapter 1: HEALTH PLAN REQUIREMENTS
24-A §4320-J. Coverage for abuse-deterrent opioid analgesic drug products

§4320-J. Coverage for abuse-deterrent opioid analgesic drug products
1.  Definitions.  As used in this section, unless the context otherwise indicates, the following terms have the following meanings.  
A. "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse.   [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
B. "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan.   [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
C. "Opioid analgesic drug product" means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, long-acting form and whether or not combined with other drug substances to form a single drug product or dosage form.   [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
[PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
2.  Required coverage.  A carrier offering a health plan in this State shall provide coverage for abuse-deterrent opioid analgesic drug products listed on any formulary, preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented.  
[PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
SECTION HISTORY
PL 2015, c. 371, §1 (NEW). PL 2015, c. 371, §2 (AFF).

Structure Maine Revised Statutes

Maine Revised Statutes

TITLE 24-A: MAINE INSURANCE CODE

Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT

Subchapter 1: HEALTH PLAN REQUIREMENTS

24-A §4301. Definitions (REPEALED)

24-A §4301-A. Definitions

24-A §4302. Reporting requirements

24-A §4303. Plan requirements

24-A §4303-A. Provider profiling programs

24-A §4303-B. Disclosure related to provider networks

24-A §4303-C. Protection from surprise bills and bills for out-of-network emergency services

24-A §4303-D. Provider directories

24-A §4303-E. Dispute resolution process for surprise bills and bills for out-of-network emergency services

24-A §4303-F. Reimbursement for ambulance services and participation of ambulance service providers in carrier networks

24-A §4304. Utilization review

24-A §4305. Quality of care

24-A §4306. Enrollee choice of primary care provider

24-A §4306-A. Patient access to obstetrical and gynecological care

24-A §4307. Construction

24-A §4308. Indemnification

24-A §4309. Adoption of rules

24-A §4309-A. Compliance with the Affordable Care Act

24-A §4310. Access to clinical trials

24-A §4311. Access to prescription drugs

24-A §4312. Independent external review

24-A §4313. Carrier liability; cause of action

24-A §4314. Access to eye care providers

24-A §4314-A. Coverage for early refills of prescription eye drops

24-A §4315. Coverage of prosthetic devices

24-A §4316. Coverage for telehealth services

24-A §4317. Pharmacy providers

24-A §4317-A. Prescription drug coverage; out-of-pocket expenses for coinsurance

24-A §4317-B. Orally administered cancer therapy

24-A §4317-C. Coverage for prescription insulin drugs; limit on out-of-pocket costs

24-A §4317-D. Coverage of HIV prevention drugs

24-A §4317-E. Coverage for emergency supply of chronic maintenance drugs

24-A §4318. Prohibition against maximum aggregate benefit provisions (REALLOCATED FROM TITLE 24-A, SECTION 4317) (REPEALED)

24-A §4318-A. Comparable health care service incentive program (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

24-A §4318-B. Access to lower-priced services (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

24-A §4319. Rebates

24-A §4319-A. Guaranteed issue

24-A §4319-B. Medical loss ratio reporting for dental insurance plans

24-A §4320. No lifetime or annual limits on health plans

24-A §4320-A. Coverage of preventive and primary health services

24-A §4320-B. Extension of dependent coverage

24-A §4320-C. Emergency services

24-A §4320-D. Comprehensive health coverage

24-A §4320-E. Reinsurance, risk corridors and risk adjustment

24-A §4320-F. Oversight of plans offered on the American Health Benefit Exchange and the SHOP Exchange

24-A §4320-G. Applicability to health plans grandfathered under the Affordable Care Act

24-A §4320-H. Payment reform pilot projects (REALLOCATED FROM TITLE 24-A, SECTION 4320)

24-A §4320-I. Coverage for the cost of testing for bone marrow donation suitability

24-A §4320-J. Coverage for abuse-deterrent opioid analgesic drug products

24-A §4320-K. Coverage for services provided by a naturopathic doctor

24-A §4320-L. Nondiscrimination

24-A §4320-M. Coverage for abortion services

24-A §4320-N. Step therapy (REALLOCATED FROM TITLE 24-A, SECTION 4320-M)

24-A §4320-O. Coverage for services provided by a physician assistant

24-A §4320-P. Coverage for health care services for COVID-19

24-A §4320-Q. Coverage for services provided by a certified registered nurse anesthetist (REALLOCATED FROM TITLE 24-A, SECTION 4320-P)

24-A §4320-R. Mandatory offer of coverage for certain adults with disabilities

24-A §4320-S. Coverage for dental services for cancer patients

24-A §4320-T. Implementation of federal mental health parity laws (WHOLE SECTION TEXT EFFECTIVE UNTIL 4/30/28) (WHOLE SECTION TEXT REPEALED 4/30/28) (REALLOCATED FROM TITLE 24-A, SECTION 4320-R)

24-A §4320-U. Coverage for fertility services (REALLOCATED FROM TITLE 24-A, SECTION 4320-S)