Maine Revised Statutes
Subchapter 1: HEALTH PLAN REQUIREMENTS
24-A §4320-M. Coverage for abortion services

§4320-M. Coverage for abortion services
1.  Required coverage.  A carrier offering a health plan in this State that provides coverage for maternity services shall provide coverage for abortion services for an enrollee in accordance with this section.  
[PL 2019, c. 274, §5 (NEW).]
2.  Limits; deductible; copayment; coinsurance.  A health plan that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section.  
[PL 2019, c. 274, §5 (NEW).]
3.  Application.  Except for a religious employer granted an exclusion as provided in subsection 4, 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 2019, c. 274, §5 (NEW).]
4.  Exclusion for religious employer.  A religious employer may request and a carrier 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 enrollees and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing a carrier to exclude coverage for abortion services that are necessary to preserve the life or health of a covered enrollee. For the purposes of this section, "religious employer" means an employer that is a church, a 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 2019, c. 274, §5 (NEW).]
5.  Protection of federal funds.  If the superintendent determines enforcement of this section may adversely affect the allocation of federal funds to the State, the superintendent may grant an exemption from the requirements of this section, but only to the minimum extent necessary to ensure the continued receipt of federal funds.  
[PL 2019, c. 274, §5 (NEW).]
Revisor's Note: §4320-M. Step therapy as enacted by PL 2019, c. 295, §1 is REALLOCATED TO TITLE 24-A, SECTION 4320-N
SECTION HISTORY
PL 2019, c. 274, §5 (NEW).

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)