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An Act To Provide Consumers of Health Care with Information Regarding Health Care Costs
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4303, sub-§20  is enacted to read:
 
20.  Information about prescription drugs.     Consistent with the requirements of the federal Affordable Care Act, a carrier offering a health plan in this State shall provide the following information to prospective enrollees and enrollees with respect to prescription drug coverage on its publicly accessible website.
 
A.  A carrier shall post each prescription drug formulary for each health plan offered by the carrier. The prescription drug formularies must be posted in a manner that allows prospective enrollees and enrollees to search the formularies and compare formularies to determine whether a particular prescription drug is covered under a formulary. When a change is made to a formulary, the updated formulary must be posted on the website within 72 hours.
 
B.  A carrier shall provide an explanation of:
 
(1) The requirements for utilization review, prior authorization or step therapy for each category of prescription drug covered under a health plan;
 
(2) The cost-sharing requirements for prescription drug coverage, including a description of how the costs of prescription drugs will specifically be applied or not applied to any deductible or out-of-pocket maximum required under a health plan;
 
(3) The exclusions from coverage under a health plan and any restrictions on use or quantity of covered health care services in each category of benefits; and
 
(4) The amount of coverage provided under a health plan for out-of-network providers or noncovered health care services and any right of appeal available to an enrollee when out-of-network providers or noncovered health care services are medically necessary.
 
Effective 90 days following adjournment of the 127th Legislature, First Regular Session, unless otherwise indicated.