Maine Statutes

Starting January 1, 2023, for individual and small group health plans, the law mandates that after the initial cost-free visit, copayments for behavioral health office visits cannot exceed those for primary care visits, and both contribute to the deductible. For larger group health plans from the same date, coverage must be provided without cost sharing for the first primary care and behavioral health office visits each plan year, with subsequent behavioral health copayments not exceeding primary care copayments after the initial visits.

The law also requires carriers to demonstrate compliance with federal mental health parity laws and directs the Superintendent of Insurance to take certain actions, including examination and reporting requirements, related to enforcement of mental health parity laws. These requirements are repealed on April 30, 2028.

Enacted through SP218/LD705 

This statute was amended to exclude employee group insurance policies issued to employers with 20 or fewer employees insured under the group policy or to group policies designed primarily to supplement to the Civilian Health and Medical Program of the Uniformed Services. Additionally, it provided that alcoholism and drug treatment patient records are confidential.

This bill changed the state insurance law by adding the sections about autism coverage. These sections have been changed very slightly since this bill was signed into law (the coverage age limit is now 10 years old, not 5 years old). These sections are summarized at the bottom of this page under “Maine Parity Law.”