From a field of 30 bills proposing additional health care mandates for insurance companies, six have made the first cut after scrutiny by a joint legislative committee. But final committee approval of any of those bills is anything but certain. Each will undergo an evaluation by the Maine Bureau of Insurance, which will weigh their costs and merits.

Studied will be expanded coverage for nurse practitioners and obstetrician-gynecologists; payments to certain nurses for surgical assistance; treatment for substance abuse and eating disorders to be covered under the same terms as physical illnesses; and parity for long-term disability insurance for physical and mental illnesses.

The Committee on Banking and Insurance this year received a record number of bills dealing with mandates, which to varying degrees require insurance companies to pay out benefits for certain conditions, illnesses or medical procedures. Lawmakers submitted bills that would require coverage for everything from in vitro fertilization to wigs for medical reasons.

In general, mandated items are limited to people insured through HMOs, or about 290,000 people in Maine. They do not affect Medicare or Medicaid coverage, nor do they affect self-insured plans for larger companies, which are protected by a federal law called ERISA.

HMOs, such as Blue Cross Blue Shield of Maine and Tufts Health Plan of New England, have opposed the large crop of mandates this year, as they have in the past. Opponents of mandates say additional coverage means raising insurance premiums.

State law requires that any proposed mandate be studied by the Bureau of Insurance to estimate its social and financial effects, as well as how much the mandate will improve the quality of patient care.

The committee has requested that three of the studies be completed in May. With committee approval, they could come before the full Legislature this session.

LD 857 would require that nurse practitioners be permitted to serve as primary care providers in HMOs if they are qualified. It also requires coverage of services by nurse practitioners and nurse midwives, if referred by primary care providers.

LD 1205 would allow women in HMOs to receive primary care from an obstetrician-gynecologist, nurse practitioner or nurse midwife without referral from a primary care physician. Under current law, a self-referral is allowed only for an annual gynecological examination.

LD 32 establishes a nursing category called “registered nurse first assistant,” whose specialty is assisting during surgeries. The bill requires that insurance companies pay for the services of these nurses.

During next year’s session, the insurance committee will get three other studies back from the Bureau of Insurance.

LD 1493 would require that long-term disability insurance policies provide benefits for 10 mental illnesses — including schizophrenia, bipolar disorder, major depression, anorexia and chemical dependency — under the same terms as physical illnesses. Rep. Joe Perry, D-Bangor, had introduced the bill at the behest of Bill Trask, a Bangor man who had his disability benefits for bipolar disorder cut off in 1997 after two years. Under the same insurance plan, benefits for physical disabilities are paid until age 65.

Trask, who would not be retroactively covered by the bill should it pass, has filed suit in federal court against his former employer and its insurance company.

LD 1000 would require that insurers provide health care coverage for substance abuse treatment under the same terms as coverage for physical conditions. LD 1158 creates the same kind of parity for bulimia and anorexia, which are eating disorders. The expanded coverage is for adults and children.