Sponsor: Representative Samuel Zager | Current Status: REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES

This bill requires insurance coverage, including coverage in the MaineCare program, for biomarker testing.

Sponsor: Rep. Joshua Morris | Current Status: DEAD

Sponsor: Representative Anne Graham | Current Status: DEAD

This bill requires the Department of Health and Human Services to provide reimbursement under the MaineCare program for glucagon-like peptide-1 receptor agonists that are approved by the federal Food and Drug Administration for the treatment of obesity. The department must restrict reimbursement to medications prescribed by a primary care provider or a bariatric specialist and must require a prior authorization of the medication.

Sponsor: Senator Stacy Brenner | Current Status: REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES

This bill requires carriers offering health plans in this State to provide coverage for blood testing for perfluoroalkyl and polyfluoroalkyl substances, or PFAS, recommended by a provider as medically necessary health care in accordance with clinical guidelines established by the National Academies of Sciences, Engineering, and Medicine. The requirements of the bill apply to health plans issued or renewed on or after January 1, 2026. The bill also includes language stating the Legislature's finding that the requirement for coverage for blood testing for perfluoroalkyl and polyfluoroalkyl substances are not an expansion of the State's essential health benefits and do not require the State to defray costs pursuant to the federal Patient Protection and Affordable Care Act.

Sponsor: Senator Stacy Brenner | Current Status: PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT

This bill requires carriers offering health plans in this State to provide coverage for blood testing for perfluoroalkyl and polyfluoroalkyl substances, or PFAS, recommended by a provider as medically necessary health care in accordance with clinical guidelines established by the National Academies of Sciences, Engineering, and Medicine. The requirements of the bill apply to health plans issued or renewed on or after January 1, 2026. The bill also includes language stating the Legislature's finding that the requirement for coverage for blood testing for perfluoroalkyl and polyfluoroalkyl substances are not an expansion of the State's essential health benefits and do not require the State to defray costs pursuant to the federal Patient Protection and Affordable Care Act.

Sponsor: Representative Laurie Osher | Current Status: DEAD

This bill requires carriers offering health plans in this State to provide coverage for glucagon-like peptide-1 receptor agonist medication approved by the federal Food and Drug Administration and prescribed by a health care provider. It also requires the Department of Professional and Financial Regulation, Bureau of Insurance to initiate an education campaign regarding the coverage requirements and the health benefits associated with the use of the medication. The requirements of the bill apply to health plans issued or renewed on or after January 1, 2026.

Sponsor: Rep. Michelle Boyer | Current Status: PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT in concurrence

This bill requires the Department of Health and Human Services to reimburse for lactation services in hospitals and in the homes of eligible persons. It requires the department to reimburse for services provided by lactation consultants certified by the International Board of Lactation Consultant Examiners. The department must apply for a state plan amendment no later than January 1, 2026 and adopt or amend rules within 6 months of approval.

Sponsor: Senator Anne Carney | Current Status: PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT in concurrence

This bill requires the Department of Health and Human Services to apply, by December 29 31, 2025, to the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services for a waiver or demonstration project or to amend a pending or current waiver or demonstration project to provide continuous eligibility to a child from birth through 5 years of age who is eligible for and enrolls in the Medicaid program. Upon the approval of such a waiver or demonstration project, it requires the department to adopt rules to establish the continuous eligibility of a child from birth through 5 years of age who is eligible for and enrolls in the Medicaid program, regardless of the child's family's change in income. Continuous eligibility must be maintained through the end of the month in which the child attains 6 years of age, but a child's eligibility to receive continuous coverage must be redetermined or terminated if the child is no longer a resident of the State, the child's parent or legal guardian requests termination of the child's eligibility, the child dies or the department determines that the child's eligibility was erroneously granted at the most recent determination, redetermination or renewal of eligibility because of agency error, fraud, abuse or perjury.

Sponsor: Senator Rachel Talbot Ross | Current Status: DEAD

This resolve establishes the Task Force to Study Equitable Access to Maternal Health Care and Birthing Facilities, which is directed to study past closures of maternal health care centers in the State, the current availability of access to maternal health care services in the State and methods to increase patient access to maternal health care services, including equitable access for vulnerable populations. The task force is required to submit a report and suggested legislation by January 6, 2026 to the Joint Standing Committee on Health and Human Services, which is authorized to report out legislation based on the report to the Second Regular Session of the 132nd Legislature.

Sponsor: Rep. James Dill | Current Status: DEAD

This bill prohibits a health care facility or provider from denying medical services or other services related to organ transplantation to an individual based solely on the individual's disability. It requires health care facilities and providers to make reasonable modifications to policies, practices and procedures to allow individuals with disabilities access to transplantation-related services. It provides that, whenever it appears that a health care facility or provider is violating the antidiscrimination provision of the bill, the affected individual may commence a civil action in Superior Court for injunctive or equitable relief against the health care facility or provider for purposes of enforcing compliance. It prohibits a health insurance carrier that offers, issues or renews a health benefit plan that provides coverage for anatomical gifts, organ transplants or related treatments or services from denying coverage for these services solely on the basis of a covered individual's disability

Sponsor: Representative Samuel Zager

This bill requires that a prior authorization for health care services remain valid for the duration of the treatment or one year, whichever is longer. It prohibits a health care plan from requiring the renewal of a prior authorization more frequently than once every 5 years for treatment that is necessary for more than one year. It also prohibits a health care plan from restricting coverage for a health care service or a prescription that was approved under a previous health care plan within 90 days of enrollment in the new health care plan and requires a health care plan to provide at least 90 days' notice to an enrollee prior to restricting coverage of a previously approved health care service.

Sponsor: Rep. Lori Gramlich | Current Status: DEAD

The department is directed to do the following: 1. Address the closure of beds for children and youth residential services by counseling service providers about resource needs and providing emergency funds to support acute staffing needs; 2. Develop an internal process to ensure that the department is meeting its obligations to make available and maximize its use of funding for early and periodic screening, diagnostic and treatment services; 3. Submit 2 additional reports to the Legislature related to the number of children experiencing long stays in hospital emergency departments and other matters related to youth services; and 4. Submit a report to the Legislature containing a gap analysis that describes all of the youth beds and programs added since 2018 and lost since 2018 and information concerning waiting lists and average time waiting for approval for youth programs. The report must also contain updates on the implementation and development of various policy efforts related to behavioral health services.

Sponsor: Rep. Lori Gramlich | Current Status: PASSED TO BE ENACTED.