An Act to Require Insurance Coverage for Glucagon-like Peptide-1 Receptor Agonist Medication

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132nd MAINE LEGISLATURE
FIRST REGULAR SESSION-2025
Legislative Document No. 627
H.P. 395 House of Representatives, February 25, 2025
An Act to Require Insurance Coverage for Glucagon-like Peptide-1
Receptor Agonist Medication
Received by the Clerk of the House on February 20, 2025. Referred to the Committee on
Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered
printed pursuant to Joint Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative STOVER of Boothbay.
Cosponsored by Representatives: ANKELES of Brunswick, DHALAC of South Portland,
GRAHAM of North Yarmouth, GRAMLICH of Old Orchard Beach, MEYER of Eliot,
ROBERTS of South Berwick, ROEDER of Bangor, SALISBURY of Westbrook.

Page 1 - 132LR0087(01)
1Be it enacted by the People of the State of Maine as follows:
2Sec. 1. 24-A MRSA §4320-W is enacted to read:
3§4320-W. Coverage for glucagon-like peptide-1 receptor agonist medication
41. Glucagon-like peptide-1 receptor agonist medication defined. For the purposes
5 of this section, unless the context otherwise indicates, "glucagon-like peptide-1 receptor
6 agonist medication" means a glucagon-like peptide-1 receptor agonist medication approved
7 by the federal Food and Drug Administration.
82. Required coverage. A carrier offering a health plan in this State shall provide
9 coverage for glucagon-like peptide-1 receptor agonist medication that is prescribed by a
10 health care provider for administration to an enrollee.
113. Limit on out-of-pocket costs. A carrier that provides coverage for prescription
12 glucagon-like peptide-1 receptor agonist medication may not impose any deductible,
13 copayment, coinsurance or other cost-sharing requirement on an enrollee for that coverage
14 that results in out-of-pocket costs to the enrollee that exceed $35 per prescription for a 30-
15 day supply of covered prescription medications under this section, regardless of the amount
16 of glucagon-like peptide-1 receptor agonist medication needed to fill the enrollee's
17 prescriptions.
184. Prior authorization prohibited. A carrier may not make coverage without cost
19 sharing as required by subsection 3 dependent on any prior authorization requirement.
20Sec. 2. Education campaign. By November 1, 2025, the Department of
21 Professional and Financial Regulation, Bureau of Insurance shall implement a campaign to
22 educate the public and health care providers regarding the coverage requirements under the
23 Maine Revised Statutes, Title 24-A, section 4320-W and the health benefits associated with
24 the use of glucagon-like peptide-1 receptor agonist medication.
25Sec. 3. Application. That section of this Act that enacts the Maine Revised Statutes,
26 Title 24-A, section 4320-W applies to all policies, contracts and certificates executed,
27 delivered, issued for delivery, continued or renewed in this State on or after January 1,
28 2026. For purposes of this Act, all contracts are deemed to be renewed no later than the
29 next yearly anniversary of the contract date.
30SUMMARY
31 This bill requires carriers offering health plans in this State to provide coverage for
32 glucagon-like peptide-1 receptor agonist medication approved by the federal Food and
33 Drug Administration and prescribed by a health care provider. It also requires the
34 Department of Professional and Financial Regulation, Bureau of Insurance to initiate an
35 education campaign regarding the coverage requirements and the health benefits associated
36 with the use of the medication. The requirements of the bill apply to health plans issued or
37 renewed on or after January 1, 2026.
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