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LD1310 • 2025

An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services

An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services

Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Senator Joseph Baldacci
Last action
2025-06-09
Official status
Signed by the Governor
Effective date
Not listed

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services

An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services Sponsor: Senator Joseph Baldacci Reference committee: Health Coverage, Insurance and Financial Services Governor action: Signed by the Governor

What This Bill Does

  • An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services Sponsor: Senator Joseph Baldacci Reference committee: Health Coverage, Insurance and Financial Services Governor action: Signed by the Governor

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Adopted by House & Senate

Plain English: Page 1 - 132LR1415(02) COMMITTEE AMENDMENT 1 L.D.

  • Page 1 - 132LR1415(02) COMMITTEE AMENDMENT 1 L.D.
  • 1310 2 Date: (Filing No.
  • S- ) 3HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES 4 Reproduced and distributed under the direction of the Secretary of the Senate.
  • 5STATE OF MAINE 6SENATE 7132ND LEGISLATURE 8FIRST SPECIAL SESSION 9 COMMITTEE AMENDMENT “ ” to S.P.

Bill History

  1. 2025-06-09 Governor

    Signed by the Governor

  2. 2025-06-02 Senate

    PASSED TO BE ENACTED , in concurrence.

  3. 2025-05-29 House

    PASSED TO BE ENACTED . Sent for concurrence. ORDERED SENT FORTHWITH.

  4. 2025-05-23 Committee

    Reported Out; OTP-AM

  5. 2025-05-01 Committee

    Work Session Held

  6. 2025-05-01 Committee

    Voted; OTP-AM

  7. 2025-03-27 Committee

    Referred to Committee on Health Coverage, Insurance and Financial Services.

Official Summary Text

An Act to Amend the Laws Governing Insurance Coverage of Preventive and Primary Health Services
Sponsor:
Senator Joseph Baldacci
Reference committee:
Health Coverage, Insurance and Financial Services
Governor action:
Signed by the Governor

Current Bill Text

Read the full stored bill text
Page 1 - 132LR1415(03)
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-FIVE
_____
S.P. 540 - L.D. 1310
An Act to Amend the Laws Governing Insurance Coverage of Preventive and
Primary Health Services
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24-A MRSA §4320-A, sub-§3-B, as enacted by PL 2021, c. 638, §3, is
amended to read:
3-B. Parity in cost sharing for primary care and behavioral health office visits;
group health plan. A group health plan, other than a small group health plan subject to
subsection 3‑A, with an effective date on or after January 1, 2023 must provide coverage
without cost sharing for the first primary care office visit and first behavioral health office
visit in each plan year. After the first behavioral health office visit, a health plan may not
apply a copayment amount to a behavioral health office visit that is greater than the
copayment for a primary care office visit. For the purposes of this subsection, “behavioral
health office visit” means an office visit to address mental health and substance use
conditions. This subsection does not apply to a plan offered for use with a health savings
account unless the federal Internal Revenue Service determines that the benefits required
by this section are permissible benefits in a high deductible health plan as defined in the
federal Internal Revenue Code, Section 223(c)(2) or to a health plan that has no deductible,
no coinsurance and out-of-pocket limits that meet the applicable federal requirements. The
superintendent may adopt rules as necessary to address the coordination of the
requirements of this subsection for coverage without cost sharing for the first primary care
visit and the requirements of this section with respect to coverage of an annual well visit.
Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5,
chapter 375, subchapter 2‑A.
APPROVED
JUNE 9, 2025
BY GOVERNOR
CHAPTER
213
PUBLIC LAW