MAINE

Overview

Maine has been active in regulating healthcare price transparency. Maine makes available the state’s All-Payer Claims Database (APCD), for which the state has collected health insurance claims information since 2003. The APCD currently holds claims from commercial insurance carriers, third party administrators (TPAs), pharmacy benefit managers (PBMs), dental benefit administrators, MaineCare (Maine Medicaid), and CMS (Medicare).

Early in 2015, Maine passed a bill that requires health benefit plans selling plans in Maine to provide beneficiaries with an online drug formulary. The state legislature also tried—but failed—to pass a bill that would have established financial penalties for entities that are required to disclose price information under Maine’s APCD and fail to do so.

In early 2018, Maine passed a bill to promote prescription drug price transparency (LD1406), which directs the Maine Health Data Organization to report on the 25 most commonly prescribed drugs that have experienced large cost hikes. The organization must establish a plan for data collection from manufacturers, and provide Maine lawmakers with an annual report on prescription drug prices beginning in April 2019. As Congress considers the CREATES Act to promote generic drug competition, Maine has become the first in the country to enact a law that would require drugs distributed in the state to be made available at a fair market price and without restrictions to generic companies for use as samples to accelerate the development of lower-cost generics.

Additionally in 2018, Maine passed legislation to maintain parts of the Affordable Care Act’s essential health benefits over the governor’s veto. On July 30, 2018, HHS approved Maine’s state innovation waiver under Section 1332 of the Affordable Care Act (ACA) to support a state-based reinsurance program (Maine Guaranteed Access Reinsurance Association). The state expects the move to lower exchange premiums for the upcoming open enrollment.

The State Database

The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare.

The Database of State Laws Impacting Healthcare Cost and Quality (SLIHCQ), created by The Source on Healthcare Price & Competition and Catalyst for Payment Reform, catalogues state legislation governing price transparency, provider market power, provider payment, provider networks, and benefit design.

Search the database across all jurisdictions on the State Overview page, or view and filter existing legislation or litigation on individual state pages. The database allows customized search and filter by keyword, key issue category, and/or jurisdiction.

*Note: Current legislative session bill updates are ongoing. Check back weekly for updates. 



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© 2018-2019 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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© 2018-2019 The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
Filter by Key Issue

Additional Resources

LEGISLATIVE CALENDAR

Maine’s current legislative session runs from 12/5/2018 – 6/19/2019. Bills from 2019 will carry over to 2020 as part of the 2019-2020 legislative term.

FY 2018-2019 BUDGET

Maine enacts budgets on a two-year cycle, beginning July 1 of each odd-numbered year. Maine’s new Biennial Budget will take effect on July 1, 2017 and is valid through June 30, 2019. To view Maine’s 2018-2019 Budget, click here.

REGULATION & ENFORCEMENT

  • Maine was one of 16 states to file an amicus brief supporting the FTC’s winning position in the Ninth Circuit appeal of St. Luke’s Health Care Sys. v. FTC, No. 14-35173 (March 7, 2014), decided February 10, 2015. The States’ brief stated that the acceleration of health care costs due to the growth of large health care provider systems had become a matter of grave concern for the states.

KEY RESOURCES