MaineMaine requires coverage for medically necessary PFAS tests from 2027
Maine insurers must cover provider-recommended, medically necessary blood tests for PFAS chemicals for plan documents signed, issued, delivered, continued, or renewed on or after January 1, 2027.
What it does
Maine health plans must cover provider-recommended, medically necessary blood tests for PFAS chemicals. Coverage applies to plan documents signed, issued, delivered, continued, or renewed on or after January 1, 2027.
The law sets aside $90,000 from the General Fund for 2026–27 to cover costs of the PFAS testing requirement, with ongoing funding beginning January 1, 2027.
The law was enacted without the Bureau of Insurance’s usual review and evaluation of requirements for insurers to cover particular health benefits.
Argument forRequired coverage could help insured patients afford PFAS blood tests when their health care provider finds testing medically necessary.
Argument againstSkipping the Bureau of Insurance review could leave lawmakers with less independent information about the coverage requirement’s costs.
More detail
Insurers must cover blood tests for PFAS, a group of chemicals, when a health care provider recommends them as medically necessary. The requirement covers people enrolled in health plans offered in Maine. Testing is presumed medically necessary when a provider finds that the patient meets testing guidelines from the National Academies of Sciences, Engineering, and Medicine, its successor, or a comparable organization. Coverage applies to policies, contracts, and certificates executed, delivered, issued for delivery, continued, or renewed on or after January 1, 2027. Contracts count as renewed no later than their next yearly anniversary.
The law sets aside $90,000 from the General Fund for the State Benefit Mandate Defrayal program, which pays costs of required insurance benefits. The Department of Administrative and Financial Services receives the money to cover costs of the PFAS blood-test coverage requirement. Funding begins January 1, 2027. The spending table lists $0 for 2025–26 and $90,000 for 2026–27.
The law exempts this coverage requirement from the usual review and evaluation of required insurance benefits. The exemption concerns review by the Bureau of Insurance within the Department of Professional and Financial Regulation.
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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.
- 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 21On motion by Senator ROTUNDO of Androscoggin PLACED ON THE SPECIAL APPROPRIATIONS TABLE pending ENACTMENT in concurrence.
- May 20Sent for concurrence. ORDERED SENT FORTHWITH.
- May 20PASSED TO BE ENACTED.Became Law
- May 14In concurrence. ORDERED SENT FORTHWITH.
- Vote recorded ACC MAJ OTP AS AMENDED REP. Result: pass.Lower
- May 14The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment "A" (S-63).Minor
- May 14Under suspension of the rules, the Bill was given its SECOND READING without REFERENCE to the Committee on Bills in the Second Reading.
- May 14Committee Amendment "A" (S-63) was READ and ADOPTED.Minor
- May 14The Bill was READ ONCE.Minor
- May 14(Yeas 115 - Nays 26 - Absent 9 - Excused 0 - Restricted - 1)
- May 14ROLL CALL NO. 136
- May 14On motion of Representative MATHIESON of Kittery, the Majority Ought to Pass as Amended Report was ACCEPTED.
- May 14Reports READ.
- May 13Sent down forthwith for concurrence
- May 13Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED by Committee Amendment "A" (S-63)Minor
- May 13Committee Amendment "A" (S-63) READ and ADOPTEDMinor
- May 13Bill READ ONCEMinor
- May 13On motion by Senator BAILEY of York The Majority Ought to Pass As Amended by Committee Amendment "A" (S-63) Report ACCEPTED
- May 13Reports READ
- May 8Reported Out - OTP-AM/ONTP
- Mar 21CARRIED OVER, in the same posture, to the next special or regular session of the 132nd Legislature, pursuant to Joint Order SP 519.
- Mar 12Voted - Divided Report
- Mar 12Work Session Held
- Feb 19Received by the Secretary of the Senate on February 19, 2025 and REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES pursuant to Joint Rule 308.2Introduced
HealthcareTaxes & Budget