Bill > LD1502

This bill updates health insurance requirements for prostate cancer screening by expanding the definition and coverage of early detection services. It requires health insurance plans to cover prostate cancer screening services recommended by a physician based on the most recently published nationally recognized clinical practice guideline, which is defined as an evidence-based guideline developed by an independent medical organization with a transparent methodology. The bill broadens the scope of covered services beyond the previous requirement of only a digital rectal examination and prostate-specific antigen test, to now include medically necessary follow-up testing such as urinary analysis, serum biomarker testing, and medical imaging like MRI. Importantly, the bill prohibits health insurers from imposing any deductibles, copayments, coinsurance, or other cost-sharing requirements for these early detection services, with an exception for health savings account plans pending IRS guidance. The new requirements will apply to all health insurance policies issued or renewed on or after January 1, 2026, effectively replacing the previous age-based (50-72 years) screening limitation with a more comprehensive, guideline-driven approach to prostate cancer screening.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=1502&snum=132