MaineMaine health plans must cover prostate screening without patient charges
Rules applying from January 1, 2027, require covered Maine health plans to pay for required prostate screening without patient charges, except certain health savings account plans.
What it does
For covered Maine health plans, required prostate screening carries no patient charges under rules applying from January 1, 2027. Health savings account plans are exempt unless the IRS allows this rule.
Covered plans must pay for prostate screening when a doctor recommends it and current medical guidelines support it. These rules apply from January 1, 2027.
Argument forScreening without patient charges could help men with covered plans get tested without having to budget for those payments.
Argument againstThe exception for health savings account plans could leave some men paying screening charges while other covered patients pay nothing.
More detail
Covered health plans must pay the full cost of required prostate cancer screening. Covered plans include nonprofit medical plans, individual and group health insurance, and health maintenance organizations. Individual and group insurance rules exclude limited-benefit policies, such as Medicare supplement and long-term care insurance. Plans used with a health savings account are exempt unless the Internal Revenue Service determines that this rule is allowed for high-deductible health plans. The law applies to policies, contracts, and certificates signed, delivered, issued for delivery, continued, or renewed in Maine on or after January 1, 2027. Contracts count as renewed no later than their next yearly anniversary.
Covered health plans must pay for prostate screening recommended by a doctor and supported by the latest nationally recognized medical guideline. Covered screening means rectal exams and prostate-specific antigen (PSA) tests for men. Guidelines must use evidence and come from an independent organization or medical professional society with a policy for handling conflicts of interest. Guidelines must explain how they were developed, review evidence about benefits and risks, and recommend ways to improve patient care. The January 1, 2027, application date follows the policy and contract triggers described above.
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Where it stands
- Introduced
- Passed 1st Chamber
- Passed 2nd Chamber
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- Apr 15Signed by Governor Janet MillsLatest
- Apr 13Subsequently, PASSED TO BE ENACTED in concurrence.Passed 2nd Chamber
- Apr 13On motion by Senator ROTUNDO of Androscoggin taken from the Special Appropriations Table.
- Apr 6On motion by Senator ROTUNDO of Androscoggin PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT in concurrence.
- Apr 2Sent for concurrence. ORDERED SENT FORTHWITH.
- Apr 2PASSED TO BE ENACTED.Became Law
- Apr 2Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED by Committee Amendment "A" (H-916) in concurrence.Minor
- Apr 2Committee Amendment "A" (H-916) READ and ADOPTED.Minor
- Apr 2READ ONCE.Minor
- Apr 2On motion by Senator BAILEY of York the Majority Ought to Pass as Amended Report ACCEPTED.
- Apr 2Reports READ.
- Mar 30Sent for concurrence. ORDERED SENT FORTHWITH.
- Mar 30The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment "A" (H-916).Minor
- Mar 30Under suspension of the rules, the Bill was given its SECOND READING without REFERENCE to the Committee on Bills in the Second Reading.
- Mar 30Committee Amendment "A" (H-916) was READ and ADOPTED.Minor
- Mar 30The Bill was READ ONCE.Minor
- Mar 30On motion of Representative MATHIESON of Kittery, the Majority Ought to Pass as Amended Report was ACCEPTED.
- Mar 30Reports READ.
- Mar 27Reported Out - OTP-AM/ONTP
- Jan 21Voted - Divided Report
- Jan 21Work Session Held
- Jan 14Work Session Held - TABLED
- 2025
- Jun 25Carried over, in the same posture, to any special or regular session of the 132nd Legislature, pursuant to Joint Order SP 800.
- May 19Carry Over Approved
- May 16Carry Over Requested
- May 15Work Session Held - TABLED
- May 8Work Session Held - TABLED
- Apr 8The Bill was REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES in concurrenceMinor
- Apr 8Sent for concurrence. ORDERED SENT FORTHWITH.
- Apr 8The Bill was REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES.Minor
- Apr 8Committee on Health Coverage, Insurance and Financial Services suggested and ordered printed.Introduced
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