§2847-D. Penalty for noncompliance with utilization review programs
A policy or certificate issued or renewed after April 8, 1994 may not contain a provision that permits, upon retroactive review and confirmation of medical necessity, the imposition of a penalty of more than $500 for failure to provide notification under a utilization review program. This section does not limit the right of insurers to deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary. [PL 1995, c. 332, Pt. M, §9 (AMD).]
SECTION HISTORY
PL 1993, c. 645, §B5 (NEW). PL 1995, c. 332, §M9 (AMD).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 35: GROUP AND BLANKET HEALTH INSURANCE
24-A §2801. Scope of chapter -- short title
24-A §2802. Group insurance defined
24-A §2803-A. Loss information
24-A §2804-A. Private purchasing alliances
24-A §2804-B. Group disability income protection plan
24-A §2805. Labor union groups
24-A §2805-A. Association groups
24-A §2807-A. Credit union groups
24-A §2808-A. Rating practices in group health insurance (REPEALED)
24-A §2808-B. Small group health plans
24-A §2809. Coverage of family, dependents; continuation of coverage
24-A §2809-A. Conversion on termination of policy or eligibility
24-A §2810. Group health insurance payments; beneficiaries
24-A §2811. Payment of expenses
24-A §2812. Readjustment of premium rate (REPEALED)
24-A §2812-A. Dividends and experience refunds
24-A §2813. "Blanket health insurance" defined
24-A §2814. Blanket health insurance; payments; beneficiaries
24-A §2815. Legal liability of policyholders
24-A §2817. Applicant's statements; waivers, amendments
24-A §2818. Statements in application
24-A §2819. New employees, members
24-A §2821. Individual certificates
24-A §2823-A. Explanation and notice to parent
24-A §2823-B. Standardized claim forms
24-A §2825. Forms for proof of loss
24-A §2826. Examination, autopsy
24-A §2827. Time for payment of benefits
24-A §2827-A. Assignment of benefits
24-A §2829-A. Disability benefit offsets
24-A §2830. Omissions, modifications: superintendent may approve
24-A §2831. Hospital, medical benefits; direct payment
24-A §2832-A. Mandated offer of domestic partner benefits
24-A §2833-A. Extension of coverage for dependent children
24-A §2833-B. Mandatory offer to extend coverage for dependent children up to 26 years of age
24-A §2833-C. Mandatory offer of coverage for certain adults with disabilities
24-A §2834. Newborn children coverage
24-A §2834-A. Maternity and routine newborn care
24-A §2834-B. Dependent special enrollment period
24-A §2834-C. Compliance with federal law
24-A §2834-D. Maternity and postpartum care
24-A §2835. Mental health services
24-A §2836. Limits on priority liens
24-A §2837. Home health care coverage
24-A §2837-A. Screening mammograms
24-A §2837-B. Acupuncture services
24-A §2837-C. Coverage for breast cancer treatment
24-A §2837-D. Medical food coverage for inborn error of metabolism
24-A §2837-E. Coverage for Pap tests
24-A §2837-F. Off-label use of prescription drugs for cancer
24-A §2837-G. Off-label use of prescription drugs for HIV or AIDS
24-A §2837-H. Coverage for prostate cancer screening (REALLOCATED FROM TITLE 24-A, SECTION 2837-F)
24-A §2838. Community health service coverage (REPEALED)
24-A §2839-A. Notice of rate increase
24-A §2839-B. Large group rates
24-A §2840-A. Coverage for chiropractic services
24-A §2841. Optional coverage for optometric services
24-A §2842. Equitable health care for substance use disorder treatment
24-A §2843. Mental health services coverage
24-A §2844. Coordination of benefits
24-A §2845. Cardiac rehabilitation coverage
24-A §2846. Acquired Immune Deficiency Syndrome
24-A §2847. Utilization review data
24-A §2847-A. Penalty for failure to notify of hospitalization
24-A §2847-D. Penalty for noncompliance with utilization review programs
24-A §2847-E. Coverage for diabetes supplies
24-A §2847-F. Gynecological and obstetrical services (REALLOCATED FROM TITLE 24-A, SECTION 2850-A)
24-A §2847-G. Coverage for contraceptives
24-A §2847-J. Coverage for hospice care services
24-A §2847-L. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
24-A §2847-M. Enrollment for individuals or families establishing eligibility for MaineCare
24-A §2847-N. Coverage for colorectal cancer screening
24-A §2847-O. Coverage for hearing aids (REALLOCATED FROM TITLE 24-A, SECTION 2847-M)
24-A §2847-Q. Coverage for services provided by independent practice dental hygienist
24-A §2847-R. Enrollment of dependent children in dental coverage
24-A §2847-U. Coverage for services provided by dental therapist