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; [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]
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 § 263a; [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]
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; and [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]
D. The carrier may limit each enrollee to one test per lifetime. [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]

[PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]

Terms Used In Maine Revised Statutes Title 24-A Sec. 4320-I

  • Carrier: means :
A. See Maine Revised Statutes Title 24-A Sec. 4301-A
  • Donor: The person who makes a gift.
  • Enrollee: means an individual who is enrolled in a health plan or a managed care plan. See Maine Revised Statutes Title 24-A Sec. 4301-A
  • Health plan: means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan, other than a plan that provides only accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care or other limited benefit coverage not subject to the requirements of the federal Affordable Care Act. See Maine Revised Statutes Title 24-A Sec. 4301-A
  • United States: includes territories and the District of Columbia. See Maine Revised Statutes Title 1 Sec. 72
  • 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.

    [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]

    SECTION HISTORY

    PL 2013, c. 603, §1 (NEW). PL 2013, c. 603, §2 (AFF).