Maine Revised Statutes
Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS
24-A §4208. Annual and interim reports

§4208. Annual and interim reports
1.  Every health maintenance organization shall file annual and quarterly financial statements substantially similar to those required of health insurers under sections 423, 423‑A and 423‑D, verified by at least 3 principal officers, and shall provide a copy of each statement to the Commissioner of Health and Human Services. The superintendent may by rule or order require the filing of more frequent reports.  
[PL 2017, c. 169, Pt. A, §11 (AMD).]
1-A.  The annual and quarterly statements must be prepared in accordance with the National Association of Insurance Commissioners annual and quarterly statement instructions and must follow practices and procedures prescribed by the National Association of Insurance Commissioners accounting practices and procedures manual for health maintenance organizations. If the health maintenance organization is operated as a division or line of business by an insurer or by a nonprofit hospital or medical service corporation, the superintendent shall designate the applicable portions of the financial statement form that must be filed, so as to eliminate information that is inapplicable to health maintenance organizations that are not separately incorporated and to minimize duplication between the statement filed under this section and the overall financial statement of the insurer or nonprofit hospital or medical service corporation.  
[PL 2017, c. 169, Pt. A, §11 (NEW).]
1-B.  Every health maintenance organization shall file an annual audit opinion substantially similar to those required of insurers under section 221‑A.  
[PL 2017, c. 169, Pt. A, §11 (NEW).]
2. 
[PL 1993, c. 313, §34 (RP).]
3.  The annual and quarterly statements must include, if required by the Commissioner of Health and Human Services or by the superintendent:  
A. A summary of information compiled pursuant to section 4204 in the form required by the Commissioner of Health and Human Services; and   [PL 2017, c. 169, Pt. A, §11 (AMD).]
B. Other information related to the performance of the health maintenance organization that is necessary to enable the superintendent to carry out the superintendent's duties under this chapter.   [PL 1993, c. 313, §35 (NEW).]
[PL 2017, c. 169, Pt. A, §11 (AMD).]
4.  The superintendent may refuse to continue or may suspend or revoke the certificate of authority of a health maintenance organization failing to file an annual or quarterly statement when due.  
[PL 2017, c. 169, Pt. A, §11 (AMD).]
SECTION HISTORY
PL 1975, c. 293, §4 (AMD). PL 1975, c. 503 (NEW). PL 1991, c. 709, §6 (AMD). PL 1993, c. 313, §§33-35 (AMD). PL 2017, c. 169, Pt. A, §11 (AMD).

Structure Maine Revised Statutes

Maine Revised Statutes

TITLE 24-A: MAINE INSURANCE CODE

Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS

24-A §4201. Short title

24-A §4202. Definitions (REPEALED)

24-A §4202-A. Definitions

24-A §4203. Establishment of health maintenance organizations

24-A §4204. Issuance of certificate of authority

24-A §4204-A. Surplus requirements

24-A §4205. Powers of health maintenance organizations

24-A §4205-A. Continuity of licensure; business combinations

24-A §4206. Governing body

24-A §4207. Evidence of coverage and charges for health care services

24-A §4207-A. Point-of-service products

24-A §4208. Annual and interim reports

24-A §4209. Information to enrollees

24-A §4210. Open enrollment

24-A §4210-A. Continuity of health insurance coverage (REPEALED)

24-A §4211. Complaint system

24-A §4212. Prohibited practices

24-A §4213. Regulation of agents

24-A §4214. Powers of insurers and nonprofit hospital or medical service corporations

24-A §4215. Examinations

24-A §4216. Suspension or revocation of certificate of authority

24-A §4217. Rehabilitation, liquidation or conservation of health maintenance organizations

24-A §4218. Regulations

24-A §4218-A. Compliance with the Affordable Care Act

24-A §4219. Administrative procedures

24-A §4220. Fees

24-A §4221. Penalties and enforcement

24-A §4222. Statutory construction and relationship to other laws

24-A §4222-A. Rules

24-A §4222-B. Applicability

24-A §4223. Filings and reports as public documents

24-A §4224. Confidentiality; liability; access to records

24-A §4224-A. Loss information (REPEALED)

24-A §4225. Commissioner of Health and Human Services' authority to contract

24-A §4226. Federal legislation

24-A §4227. Choice of alternative coverage

24-A §4228. Utilization review data

24-A §4229. Acquired Immune Deficiency Syndrome

24-A §4230. Trade practices and frauds (REPEALED)

24-A §4231. Insolvency or withdrawal; alternative coverage

24-A §4232. Replacement coverage

24-A §4233. Registration, regulation and supervision of holding company systems

24-A §4233-A. Extension of coverage for dependent children

24-A §4233-B. Mandatory offer to extend coverage for dependent children up to 26 years of age

24-A §4233-C. Mandatory offer of coverage for certain adults with disabilities

24-A §4234. Child coverage

24-A §4234-A. Mental health services coverage

24-A §4234-B. Maternity and routine newborn care

24-A §4234-C. Newborn children coverage

24-A §4234-D. Off-label use of prescription drugs for cancer

24-A §4234-E. Off-label use of prescription drugs for HIV or AIDS

24-A §4234-F. Maternity and postpartum care

24-A §4235. Standardized claim forms

24-A §4236. Chiropractors in health maintenance organizations

24-A §4237. Coverage for breast cancer treatment

24-A §4237-A. Screening mammograms

24-A §4238. Medical food coverage for inborn error of metabolism

24-A §4239. Medical child support

24-A §4240. Coverage for diabetes supplies

24-A §4241. Gynecological and obstetrical services

24-A §4242. Coverage for Pap tests (REALLOCATED FROM TITLE 24-A, SECTION 4240)

24-A §4243. Limits on priority liens; subrogation

24-A §4244. Coverage for prostate cancer screening (REALLOCATED FROM TITLE 24-A, SECTION 4243)

24-A §4245. NCQA accreditation survey report

24-A §4246. Coverage for services provided by registered nurse first assistants

24-A §4247. Coverage for contraceptives (REALLOCATED FROM TITLE 24-A, SECTION 4245)

24-A §4248. Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives (REALLOCATED FROM TITLE 24-A, SECTION 4245)

24-A §4249. Mandated offer of domestic partner benefits

24-A §4250. Coverage for hospice care services (REALLOCATED FROM TITLE 24-A, SECTION 4249)

24-A §4251. Coverage for general anesthesia for dentistry (REALLOCATED FROM TITLE 24-A, SECTION 4249)

24-A §4252. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery

24-A §4253. Enrollment for individuals or families establishing eligibility for MaineCare

24-A §4254. Coverage for colorectal cancer screening

24-A §4255. Coverage for hearing aids (REALLOCATED FROM TITLE 24-A, SECTION 4253)

24-A §4256. Coverage for medically necessary infant formula (REALLOCATED FROM TITLE 24-A, SECTION 4254)

24-A §4257. Coverage for services provided by independent practice dental hygienist

24-A §4258. Coverage for children's early intervention services

24-A §4259. Coverage for the diagnosis and treatment of autism spectrum disorders (REALLOCATED FROM TITLE 24-A, §4258)

24-A §4260. Dental benefit waiting period