Legislation


LD 636 – Maine

Status: Enacted
Year Introduced: 2015
Link: https://legiscan.com/ME/text/LD636/id/1251583/Maine-2015-LD636-Chaptered.pdf

AN ACT TO PROVIDE CONSUMERS OF HEALTH CARE WITH INFORMATION REGARDING HEALTH CARE COSTS: requires carriers that offer health plans in Maine to provide enrollees and prospective enrollees with information, on a publicly accessible website, regarding: (i) each prescription drug formulary for each health plan it offers (and updates to the formulary would need to be posted within 72 hours); (ii) the requirements for utilization review, prior authorization, or step therapy for each prescription drug covered by the health plan; (iii) cost-sharing requirements for prescription drug use, including how it will affect deductibles; (iv) plan exclusions; and (v) the amount of coverage provided under a health plan for out-of-network providers or non-covered health care services, as well as any right of appeal.


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