Carriers must also provide an explanation as to why certain benefits are not being covered in the space provided (e.g., do not provide dependent coverage, do not provide dental, no RX coverage unless group purchases, etc.). Abuse-deterrent opioid 24-A M.R.S.A. A carrier offering a health plan in this State shall provide coverage for ☐ analgesic drug §4320-J abuse-deterrent opioid analgesic drug products listed on any formulary, products preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse. B. "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan. C. "Opioid analgesic drug product" means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, form and whether or not combined with other drug substances to form a single drug product or dosage form. Anesthesia for 24-A M.R.S.A. Anesthesia & associated facility charges for dental procedures are ☐ Dentistry mandated benefits for certain vulnerable persons. Autism Spectrum All group health insurance policies, contracts and certificates must ☐ Disorders provide coverage for autism spectrum disorders for an individual covered under a policy, contract or certificate in accordance with the following.
Carriers must also provide an explanation as to why certain benefits are not being covered in the space provided (e.g., do not provide dependent coverage, do not provide dental, no RX coverage unless group purchases, etc.). Abuse-deterrent opioid analgesic drug products 24-A M.R.S.A. §4320-J A carrier offering a health plan in this State shall provide coverage for abuse-deterrent opioid analgesic drug products listed on any formulary, preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse. B. "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan. C. "Opioid analgesic drug product" means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, form and whether or not combined with other drug substances to form a single drug product or dosage form. ☐ Anesthesia for Dentistry 24-A M.R.S.A. Anesthesia & associated facility charges for dental procedures are mandated benefits for certain vulnerable persons. ☐ Autism Spectrum Disorders All group health insurance policies, contracts and certificates must provide coverage for autism spectrum disorders for an individual covered under a policy, contract or certificate in accordance with the following. ☐
group_similar_supplementa.docx