132nd MAINE LEGISLATURE
		LD 178		LR 578(03)
	An Act Regarding Coverage for Step Therapy for Metastatic Cancer
	Fiscal Note for Bill as Engrossed with: C "A" (H-272)
	Committee: Health Coverage, Insurance and Financial Services
Fiscal Note
			FY 2025-26	FY 2026-27	Projections  FY 2027-28	Projections  FY 2028-29
Net Cost (Savings)
	General Fund		$0	$7,176	$7,176	$7,176
	Highway Fund		$0	$2,496	$2,496	$2,496
Appropriations/Allocations
	General Fund		$0	$7,176	$7,176	$7,176
	Highway Fund		$0	$2,496	$2,496	$2,496
Fiscal Detail and Notes
	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).