™Your Policy Risk Impact Agent
16 chapters · 66 sections in this title.
24 M.R.S. § 2332-E Standardized claim forms
1.2K chars
All nonprofit hospital or medical service organizations and nonprofit health care plans providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed health care practitioner must accept the current standardized claim form for professio…
24 M.R.S. § 2332-F Coverage for diabetes supplies
1.0K chars
All individual and group nonprofit hospital and medical services plan policies, contracts and certificates and all nonprofit health care plan policies, contracts and certificates must provide coverage for the medically appropriate and necessary equipment, limited to insulin, oral…
24 M.R.S. § 2332-G Gynecological and obstetrical services
2.0K chars
1. Coverage in managed care plans. With respect to managed care plans that require subscribers to select primary care physicians, a nonprofit hospital and medical service organization that issues group contracts and certificates must meet the following requirements. A. The organi…
24 M.R.S. § 2332-H Assignment of benefits
0.3K chars
All contracts providing benefits for medical or dental care on an expense-incurred basis must contain a provision permitting the insured to assign benefits for such care to the provider of the care. An assignment of benefits under this section does not affect or limit the payment…
24 M.R.S. § 2332-I Effective date of cancellation
0.7K chars
Contracts that do not provide for any refund of premium when a subscriber requests cancellation prior to the end of the period for which premiums have been paid must state that no refund is payable and that the cancellation will take effect at the end of the period for which prem…
24 M.R.S. § 2332-J Coverage for contraceptives
5.8K chars
1. Coverage requirements. All individual and group nonprofit hospital and medical services plan policies and contracts and all nonprofit health care plan policies and contracts that provide coverage for prescription drugs or outpatient medical services must provide coverage for a…
24 M.R.S. § 2332-K Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives
1.8K chars
1. Required coverage for services upon referral of primary care provider. A nonprofit hospital or a medical service organization that issues individual and group health care contracts shall provide coverage under those contracts for services performed by a certified nurse practit…
24 M.R.S. § 2332-L Coverage for services provided by registered nurse first assistants
2.6K chars
1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Perioperative nursing" means a practice of nursing in which the nurse provides preoperative, intraoperative and postoperative nursing care to surg…
24 M.R.S. § 2332-M Coverage for general anesthesia for dentistry
3.6K chars
1. Enrollee defined. For the purposes of this section, unless the context otherwise indicates, "enrollee" means a person who is covered under an individual or group health insurance contract provided by a nonprofit hospital and medical service organization. 2. General anesthesia …
24 M.R.S. § 2332-N Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
0.4K chars
All individual and group nonprofit hospital and medical services plan policies, contracts and certificates and all nonprofit health care plan policies, contracts and certificates must make available coverage for breast reduction surgery and symptomatic varicose vein surgery deter…
24 M.R.S. § 2342 Review entities
3.5K chars
1. Licensure. A person, partnership or corporation, other than an insurer or nonprofit service organization, health maintenance organization, preferred provider organization or an employee of those exempt organizations, that performs medical utilization review services on behalf …
24 M.R.S. § 2343 Minimum standards
1.4K chars
A utilization review program of the applicant must meet the following minimum standards. [PL 1989, c. 556, Pt. C, §1 (NEW).] 1. Notification of adverse decisions. Notification of an adverse decision by the utilization review agent must be provided to the insured or other party de…
24 M.R.S. § 2344 Utilization review services
1.3K chars
As used in this subchapter, unless the context indicates otherwise, "utilization review services" or "medical utilization review services" means a program or process by which a person, partnership or corporation, on behalf of an insurer, nonprofit service organization, 3rd-party …
24 M.R.S. § 2345 Enforcement
1.9K chars
The following provisions govern enforcement of this chapter. [PL 1989, c. 556, Pt. C, §1 (NEW).] 1. Periodic reviews. The superintendent may conduct periodic reviews of the operations of the entities licensed pursuant to this subchapter to ensure that they continue to meet the mi…
24 M.R.S. § 2349-A Medical child support
0.1K chars
A corporation organized pursuant to this chapter must comply with 42 United States Code, Section 1396g-1.
24 M.R.S. § 2370 Notification prior to cancellation
0.6K chars
The superintendent shall, by January 1, 1991, adopt rules in accordance with the Maine Administrative Procedure Act, to provide for notification of the subscriber and another person, if designated by the subscriber, prior to cancellation of health care coverage for nonpayment of …