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132nd MAINE LEGISLATURE |
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LD 178 |
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LR 578(02) |
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An Act Regarding
Coverage for Step Therapy for Advanced Metastatic Cancer |
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Fiscal Note for
Bill as Amended by Committee Amendment " " |
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Committee: Health Coverage, Insurance and
Financial Services |
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Fiscal Note Required: Yes |
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| Fiscal Note |
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FY 2025-26 |
FY 2026-27 |
Projections FY 2027-28 |
Projections FY 2028-29 |
| Net Cost
(Savings) |
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General Fund |
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$0 |
$7,176 |
$7,176 |
$7,176 |
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Highway Fund |
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$0 |
$2,496 |
$2,496 |
$2,496 |
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| Appropriations/Allocations |
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General Fund |
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$0 |
$7,176 |
$7,176 |
$7,176 |
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Highway Fund |
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$0 |
$2,496 |
$2,496 |
$2,496 |
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| Fiscal Detail
and Notes |
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This bill
prohibits health insurance carriers and utilization review organizations from
requiring enrollees to use step therapy protocols before the carrier provides
coverage of prescription drugs approved by the United States Food and Drug
Administration with respect to coverage of prescription drugs on the
carrier's formulary for the treatment of metastatic cancer and associated
conditions.
The requirements of the bill apply to health plans issued or renewed on or
after January 1, 2026. The State Employee Health Plan's first impacted plan
year will be fiscal year 2026-27 and is estimated to cost $15,600 annually
thereafter. The costs are split across the General Fund ($7,176), Highway
Fund ($2,496), and all other funds ($5,928). |
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