# Maine LD 378: An Act to Clarify That Health Insurers Must Comply with Plan Sponsors' Statutory Rights to Audit Claims and Data Requests Related to Those Audits Maine LD 378, An Act to Clarify That Health Insurers Must Comply with Plan Sponsors' Statutory Rights to Audit Claims and Data Requests Related to Those Audits, is a 132nd Maine Legislature (2025-2026) Senate bill sponsored by Donna Bailey (Democratic); status signed, last action 2026-04-13 (Signed by Governor, ACTPUB Chapter 652); PRIA reads it as touching household money (as of 2026-10-17). - Canonical: https://policyrisk.com/state-bill/ME-LD378-132 - As of: 2026-10-17 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Maine LD 378 - State: Maine - Session: 132nd Maine Legislature (2025-2026) - Title: An Act to Clarify That Health Insurers Must Comply with Plan Sponsors' Statutory Rights to Audit Claims and Data Requests Related to Those Audits - Status: signed - Chamber: Senate - Introduced: 2025-02-04 - Last action: 2026-04-13, Signed by Governor, ACTPUB Chapter 652 - Sponsor: Donna Bailey (Democratic) - Cosponsors: 0 - Subjects: HEALTH CARE SERVICES, HEALTH CARE SERVICES - DELIVERY - Touches household money: yes - Economic provisions PRIA read: 3 ## Summary No summary available. ## Bill overview: provisions PRIA read - Audit and data rights for plan sponsors: mixed, low. Plan sponsors can audit paid health claims once a year, no sooner than 6 months after the last request. After you certify HIPAA-compliant use, administrators must share plan-level files within 30 business days. Data includes claims and remittance files, billed vs. paid amounts, and all fees and dis… - Pharmacy benefit managers must share data: mixed, low. Plan sponsors can audit paid prescription claims once a year, with at least 6 months between requests. After HIPAA certification, PBMs must provide plan-level data within 30 business days. Data must include claims and remittance files, all fees and revenues, rebates by drug or category, and all man… - When these transparency rules take effect: mixed, low. The law takes effect on approval under an emergency clause. It also states an effective date of July 1, 2026. ## Sponsors and cosponsors - Sponsor: Donna Bailey (Democratic), Senate ## Actions (9) - 2026-04-13: Signed by Governor, ACTPUB Chapter 652 - 2026-04-07: PASSED TO BE ENACTED - Emergency - 2/3 Elected Required, in concurrence. (Senate) - 2026-04-07: This being an emergency measure, a two-thirds vote of all the members elected to the House was necessary.PASSED TO BE ENACTED.Sent for concurrence. ORDERED SENT FORTHWITH. (House) - 2026-04-06: CONSENT CALENDAR - FIRST DAYUnder suspension of the rules CONSENT CALENDAR - SECOND DAY.The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment "A" (S-624).In concurrence. ORDERED SENT FORTHWITH. (House) - 2026-04-06: Report READ and ACCEPTED.READ ONCE.Committee Amendment "A" (S-624) READ and ADOPTED.Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED BY Committee Amendment "A" (S-624).Ordered sent down forthwith for concurrence. (Senate) - 2025-06-25: CARRIED OVER, in the same posture, to any special or regular session of the 132nd Legislature, pursuant to Joint Order SP 800. (Senate) - 2025-03-21: CARRIED OVER, in the same posture, to the next special or regular session of the 132nd Legislature, pursuant to Joint Order SP 519. (Senate) - 2025-02-04: The Bill was REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES.In concurrence. ORDERED SENT FORTHWITH. (House) - 2025-02-04: Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES suggested and ordered printed REFERENCE to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES Ordered sent down forthwith for concurrence (Senate) ## Bill text - Amendment C-A (S-624), adopted by House & Senate: [PDF](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=2&snum=132) - Enacted: [PDF](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=3&snum=132) - Introduced: [PDF](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=1&snum=132) ## Related bills - LD 1522: An Act to Establish the Maine Eviction Prevention Program (failed) - LD 1665: An Act to Provide Property Tax Relief to Maine Families (failed) - LD 1872: An Act to Reinvest in the Pension Funds of the Maine Public Employees Retirement System (failed) - LD 2067: An Act to Include Community Mental Health Workers Under the 1998 Special Plan for Retirement (failed) - LD 1611: An Act to Decrease the Retirement Contributions Required for Teachers and State Employees (failed) - LD 1294: An Act to Expand the Dependent Exemption Tax Credit (failed) ## Sources - [Amendment C-A (S-624), adopted by House & Senate (PDF)](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=2&snum=132) - [Enacted (PDF)](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=3&snum=132) - [Introduced (PDF)](https://legislature.maine.gov/legis/bills/getPDF.asp?paper=SP0135&item=1&snum=132) ## Related - [LD 1522: An Act to Establish the Maine Eviction Prevention Program](https://policyrisk.com/state-bill/ME-LD1522-132) - [LD 1665: An Act to Provide Property Tax Relief to Maine Families](https://policyrisk.com/state-bill/ME-LD1665-132) - [LD 1872: An Act to Reinvest in the Pension Funds of the Maine Public Employees Retiremen…](https://policyrisk.com/state-bill/ME-LD1872-132) - [LD 2067: An Act to Include Community Mental Health Workers Under the 1998 Special Plan f…](https://policyrisk.com/state-bill/ME-LD2067-132) - [LD 1611: An Act to Decrease the Retirement Contributions Required for Teachers and State…](https://policyrisk.com/state-bill/ME-LD1611-132) - [LD 1294: An Act to Expand the Dependent Exemption Tax Credit](https://policyrisk.com/state-bill/ME-LD1294-132) - [Maine bills](https://policyrisk.com/states/maine/bills) - [Maine state hub](https://policyrisk.com/states/maine) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/ME-LD378-132 (as of 2026-10-17).