Bill > LD1310

This bill amends existing insurance law to require group health plans (with some exceptions) to provide coverage without cost sharing for the first primary care and first behavioral health office visit in each plan year. After the first behavioral health visit, the plan cannot charge a higher copayment for behavioral health visits than for primary care visits. The term "behavioral health office visit" is specifically defined as an office visit addressing mental health and substance use conditions. The bill adds an additional exemption for health plans that have no deductible and meet certain out-of-pocket limit requirements. The legislation does not apply to plans used with health savings accounts unless the Internal Revenue Service determines the benefits are permissible in high-deductible health plans. The superintendent of insurance is authorized to adopt rules to coordinate these requirements with existing coverage provisions for annual well visits. This amendment aims to improve access to primary and mental health care by reducing financial barriers to initial medical consultations.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1310&snum=132