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LD178 • 2025

An Act Regarding Coverage for Step Therapy for Metastatic Cancer

An Act Regarding Coverage for Step Therapy for Metastatic Cancer

Enacted

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

Sponsor
Representative Kristi Mathieson
Last action
2025-07-01
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 Regarding Coverage for Step Therapy for Metastatic Cancer

An Act Regarding Coverage for Step Therapy for Metastatic Cancer Sponsor: Representative Kristi Mathieson Reference committee: Health Coverage, Insurance and Financial Services Governor action: Signed by the Governor

What This Bill Does

  • An Act Regarding Coverage for Step Therapy for Metastatic Cancer Sponsor: Representative Kristi Mathieson 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 - 132LR0578(02) COMMITTEE AMENDMENT 1 L.D.

  • Page 1 - 132LR0578(02) COMMITTEE AMENDMENT 1 L.D.
  • 178 2 Date: (Filing No.
  • H- ) 3HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES 4 Reproduced and distributed under the direction of the Clerk of the House.
  • 5STATE OF MAINE 6HOUSE OF REPRESENTATIVES 7132ND LEGISLATURE 8FIRST SPECIAL SESSION 9 COMMITTEE AMENDMENT “ ” to H.P.

Bill History

  1. 2025-07-01 Governor

    Signed by the Governor

  2. 2025-06-25 Senate

    On motion by Senator ROTUNDO of Androscoggin taken from the Special Appropriations Table 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. 2025-02-12 Committee

    Work Session Held

  6. 2025-02-12 Committee

    Voted; OTP-AM

  7. 2025-01-14 Committee

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

Official Summary Text

An Act Regarding Coverage for Step Therapy for Metastatic Cancer
Sponsor:
Representative Kristi Mathieson
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 - 132LR0578(03)
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-FIVE
_____
H.P. 111 - L.D. 178
An Act Regarding Coverage for Step Therapy for Metastatic Cancer
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24-A MRSA §4320-N, sub-§1, ¶A-1 is enacted to read:
A-1. "Associated conditions" means the symptoms or side effects associated with
metastatic cancer or its treatment and that, in the judgment of the health care
practitioner, further jeopardize the health of a patient if left untreated.
Sec. 2. 24-A MRSA §4320-N, sub-§1, ¶C-1 is enacted to read:
C-1. "Metastatic cancer" means cancer that has spread from the primary or original
site of the cancer to nearby tissues, lymph nodes or other areas or parts of the body.
Sec. 3. 24-A MRSA §4320-N, sub-§8 is enacted to read:
8. Step therapy for metastatic cancer and associated conditions prohibited.
Notwithstanding subsection 6, paragraph B, with respect to coverage of a prescription drug
on a carrier's formulary for the treatment of metastatic cancer and associated conditions, a
carrier or utilization review organization may not require that the enrollee use a step therapy
protocol before the carrier provides coverage of a prescription drug approved by the United
States Food and Drug Administration.
Sec. 4. Appropriations and allocations. The following appropriations and
allocations are made.
ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF
Departments and Agencies - Statewide 0016
Initiative: Provides funding to allow enrollees to use step therapy protocols before the
carrier provides coverage of prescription drugs approved by the United States Food and
Drug Administration. The expanded requirements apply to health plans issued or renewed
on or after January 1, 2026.
GENERAL FUND 2025-26 2026-27
All Other $0 $7,176
__________ __________
APPROVED
JULY 1, 2025
BY GOVERNOR
CHAPTER
448
PUBLIC LAW
Page 2 - 132LR0578(03)
GENERAL FUND TOTAL $0 $7,176

HIGHWAY FUND 2025-26 2026-27
All Other $0 $2,496
__________ __________
HIGHWAY FUND TOTAL $0 $2,496