§ 32 §13725 — Insulin Safety Net Program (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/01/27) (WHOLE SECTION TEXT REPEALED 1/01/27)

1.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
2.
Insulin Safety Net Program established.
The board shall establish the Insulin Safety Net Program, referred to in this section as "the program," in accordance with the requirements of this section. Under the program, by March 1, 2022, each manufacturer shall establish procedures to make insulin available in accordance with this section and as required under subsections 3 and 4 to pharmacies for dispensing to eligible individuals who are in urgent need of insulin or who need access to an affordable insulin supply.
3.
Urgent need safety net.
A pharmacy shall dispense a 30-day supply of insulin, as permitted under section 13786‑D, to an eligible individual in urgent need of insulin in accordance with this subsection.
4.
Manufacturer's patient assistance.
A manufacturer shall establish a patient assistance program to provide access to insulin to any eligible individual who meets the requirements of this subsection and who demonstrates a continued need for insulin. Each manufacturer's patient assistance program must meet the requirements of this subsection.
5.
Additional 30-day urgent-need insulin supply pending eligibility for other coverage or assistance.
If an individual has applied for MaineCare coverage but has not been determined eligible or has been determined eligible but MaineCare coverage has not become effective or if the individual has been determined ineligible for the manufacturer's patient assistance program by the manufacturer and the individual has requested a review pursuant to subsection 4, paragraph G but the reviewer has not rendered a decision, the individual is entitled to access insulin under the provisions of subsection 3 if the individual has an urgent need of insulin. To access insulin under this subsection, the individual must attest to the pharmacy that the individual meets the requirements of subsection 2.
6.
Dissemination of information about program.
In consultation with the Health Insurance Consumer Assistance Program, established in Title 24‑A, chapter 56‑A, subchapter 2‑A, the board shall develop an information sheet to post on its publicly accessible website and provide a link to the information sheet on the website to be used by pharmacies, health care practitioners, hospital emergency departments, urgent care clinics and community health clinics. The information sheet must contain: a description of the urgent need insulin safety net, including how to apply for the benefits of the program; a description of each insulin manufacturer's patient assistance program, including contact information for accessing the assistance programs for each manufacturer; information on how to contact the Health Insurance Consumer Assistance Program, established in Title 24‑A, chapter 56‑A, subchapter 2‑A; and information on how to contact the board if a manufacturer determines that an individual is not eligible for the manufacturer's patient assistance program.
7.
Enforcement; penalty for noncompliance.
A person who violates this chapter is subject to enforcement action by the board through any board action authorized in accordance with section 13731 or any civil penalty or criminal or civil action authorized in section 13731.
8.
Confidential information.
Any health information or records provided to the board under this section are confidential if the information or records identify or permit the identification of an individual who is seeking to access urgently needed insulin under subsection 3 or to participate in a manufacturer's patient assistance program under this section. A manufacturer shall maintain the confidentiality of any information received from any individual applying for the manufacturer's patient assistance program under this section and is prohibited from selling, sharing or disseminating data received under this section unless required to under this section or unless the individual has provided the manufacturer with a signed authorization.
9.
Reports.
Beginning February 15, 2023 and annually thereafter, each manufacturer shall report to the board on the number of Maine residents who accessed and received insulin on an urgent-need basis in the preceding calendar year; the number of Maine residents participating in the manufacturer's patient assistance program in the preceding calendar year, including the number of Maine residents who the manufacturer determined were ineligible for its patient assistance program; and the total value of the insulin, determined by the wholesale acquisition cost of the insulin, provided by the manufacturer in the preceding calendar year. Beginning April 15, 2023 and annually thereafter, the board shall submit a report of the aggregate information reported by manufacturers pursuant to this subsection to the joint standing committee of the Legislature having jurisdiction over health coverage, insurance and financial services matters.
10.
Repeal.
This section is repealed January 1, 2027.

Legislative History

PL 2021, c. 303, §1 (NEW).