HP1172
LD 1600
Session - 126th Maine Legislature
C "B", Filing Number H-756, Sponsored by
LR 2402
Item 3
Bill Tracking, Additional Documents Chamber Status

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

Sec. 1. 24-A MRSA §4320-I  is enacted to read:

§ 4320-I Coverage for the cost of testing for bone marrow donation suitability

1 Required coverage.   A carrier offering a health plan in this State shall provide coverage for laboratory fees up to $150 arising from human leukocyte antigen testing performed to establish bone marrow transplantation suitability in accordance with the following requirements:
A The enrollee covered under the health plan must meet the criteria for testing established by the National Marrow Donor Program, or its successor organization;
B The testing must be performed in a facility that is accredited by a national accrediting body with requirements that are substantially equivalent to or more stringent than those of the College of American Pathologists and is certified under the federal Clinical Laboratories Improvement Act of 1967, 42 United States Code, Section 263a;
C At the time of the testing, the enrollee covered under the health plan must complete and sign an informed consent form that authorizes the results of the test to be used for participation in the National Marrow Donor Program, or its successor organization, and acknowledges a willingness to be a bone marrow donor if a suitable match is found;
D The carrier may limit each enrollee to one test per lifetime; and
E The carrier may limit the scope of coverage to an enrollee who is an immediate family member of an individual for whom a bone marrow transplant has been determined medically necessary or who becomes a donor as part of a donor drive conducted on behalf of an individual for whom a bone marrow transplant has been determined medically necessary.
2 Prohibition on cost-sharing.   A carrier may not impose any deductible, copayment, coinsurance or other cost-sharing requirement on an enrollee for the coverage required under this section.

Sec. 2. Application. The requirements of this Act apply to all policies, contracts and certificates subject to this Act that are executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 2015. For purposes of this Act, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date.’

summary

This amendment is a minority report of the committee and replaces the bill. This amendment requires carriers offering health plans in this State to provide coverage for laboratory fees up to $150 arising from human leukocyte antigen testing performed to establish bone marrow transplantation suitability and prohibits carriers from imposing any cost-sharing requirement on enrollees for the test. The amendment specifies that enrollees in a health plan must meet the criteria for testing established by the National Marrow Donor Program and sign an informed consent form at the time of testing along with an acknowledgment that the enrollee is willing to be a donor if a suitable match is found. Testing is limited to once per lifetime. Unlike the majority report, this amendment limits the scope of coverage to immediate family members and donor drives conducted for a specified individual donee.

The amendment applies to all health plan policies and contracts issued or renewed on or after January 1, 2015.


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