LD 1168
pg. 4
Page 3 of 5 An Act to Provide Equity in Prescription Insurance for Contraceptive Coverage ... Page 5 of 5
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LR 150
Item 1

 
term "outpatient contraceptive services" means consultations,
examinations, procedures and medical services provided on an
outpatient basis and related to the use of contraceptive methods to
prevent an unintended pregnancy.

 
2.__Prohibitions.__A health maintenance organization that
offers an individual or group health contract may not:

 
A.__Deny to any individual or covered person eligibility or
continued eligibility to enroll or to renew coverage under
the terms of the contract because of the individual's or
covered person's use or potential use of items or services
that are covered in accordance with the requirements of this
section;

 
B.__Provide monetary payments or rebates to a covered person
to encourage that person to accept less than the minimum
protections available under this section;

 
C.__Penalize or otherwise reduce or limit the reimbursement
of a health care professional because that professional
prescribed contraceptive drugs or provided contraceptive
services in accordance with this section; or

 
D.__Provide incentives, monetary or otherwise, to a health
care professional to induce that professional to withhold
from a covered person contraceptive drugs or contraceptive
services.

 
Sec. 5. Applicability. This Act applies to all policies and contracts
executed, delivered, issued for delivery, continued or renewed on
or after the effective date of this Act. All policies and
contracts are deemed to be renewed no later than the next yearly
anniversary of the contract date.

 
SUMMARY

 
This bill requires insurance policies and contracts that
provide coverage for prescription drugs or outpatient medical
services to provide coverage for prescription contraceptives
approved by the federal Food and Drug Administration or for
outpatient contraceptive services, respectively, to the same
extent that coverage is provided for other prescription drugs or
outpatient medical services. This requirement may be enforced
through the appeals process required for insurance policies and
contracts by current law or through appropriate action by the


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