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132nd MAINE LEGISLATURE
FIRST REGULAR SESSION-2025
Legislative Document No. 784S.P. 343 In Senate, March 4, 2025
An Act to Require Health Insurance Coverage for Specialized Risk
Screening for First Responders
Received by the Secretary of the Senate on February 26, 2025. Referred to the Committee
on Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered
printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator BAILEY of York.
Cosponsored by Representative COPELAND of Saco and
Senators: NANGLE of Cumberland, TIPPING of Penobscot, Representatives: MATHIESON
of Kittery, SHAGOURY of Hallowell. Page 1 - 132LR0577(01)
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2 is enacted to read:
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6 following terms have the following meanings.
7 A. "First responder" means an employee or occasional employee or volunteer that is a
8 member of a state, county or municipal government entity that provides or has the
9 authority to provide fire, emergency medical, emergency communications, correctional
10 or police services.
11 B. "Specialized risk screening" means any of the following standard, medically
12 accepted tests:
13 (1) Tests for evidence of any cancer with a known employment-related risk of
14 exposure for a first responder;
15 (2) Blood tests, including tests conducted for a complete blood count,
16 comprehensive metabolic panel, renal panel and hepatic panel;
17 (3) Mammography, colonoscopy or prostate examinations regardless of the age of
18 the person who is the subject of the examination;
19 (4) Tests of any measure of serum activity of lipoprotein-associated phospholipase
20 enzyme A2, oxidized low-density lipoprotein or additional indicators of
21 endovascular inflammation; or
22 (5) Tests to measure vitamin deficiencies, nutritional deficits and mineral levels.
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24 enrollee meets the following conditions:
25 A. The enrollee is a first responder;
26 B. As determined by the enrollee's provider, the enrollee's receipt of specialized risk
27 screening has meaningful potential for preventive clinical benefit to the enrollee; and
28 C. The enrollee's provider has determined that specialized risk screening is medically
29 appropriate based upon the satisfaction of the conditions in paragraphs A and B.
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31 State may not deny coverage to an enrollee for specialized risk screening recommended by
32 a provider pursuant to subsection 2.
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34 A to the contrary, a carrier may not subject any specialized risk screening to any prior
35 authorization requirement, except that:
36 A. A carrier may request verification of an enrollee's status as a first responder; and
37 B. A carrier may request prior authorization if the specialized risk screening will be
38 conducted by a recognized first responder health or wellness care provider, as defined
39 in rules adopted by the bureau, or a laboratory not affiliated with the enrollee's provider. Page 2 - 132LR0577(01)
40 Rules adopted pursuant to this paragraph are routine technical rules as defined in Title
41 5, chapter 375, subchapter 2-A.
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4 coinsurance or other cost-sharing requirement for the costs of specialized risk screening.
5 This subsection does not apply to a health plan offered for use with a health savings account
6 unless the federal Internal Revenue Service determines that the requirements in this
7 subsection are permissible in a high deductible health plan as defined in the federal Internal
8 Revenue Code, Section 223(c)(2).
9 The requirements of this Act apply to all policies, contracts and
10 certificates executed, delivered, issued for delivery, continued or renewed in this State on
11 or after January 1, 2027. For purposes of this Act, all contracts are deemed to be renewed
12 no later than the next yearly anniversary of the contract date.
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14 For policies issued or renewed on or after January 1, 2027, this bill prohibits a health
15 insurance carrier from denying coverage to an enrollee who is a first responder for
16 specialized risk screening recommended by a health care provider. It limits the ability of a
17 health insurance carrier to require prior authorization for specialized risk screening. It also
18 prohibits a carrier from imposing any out-of-pocket costs for specialized risk screening
19 except for high deductible health plans offered for use in connection with a health savings
20 account to the extent required under federal regulations.
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