§4215. Examinations
1. The superintendent may make an examination of the affairs of any health maintenance organization as often as the superintendent considers it necessary for the protection of the interests of the people of this State, but not less frequently than once every 3 years. The superintendent may defer making an examination for no more than 2 additional years. In lieu of the superintendent's making an examination of a foreign or alien health maintenance organization, the superintendent may accept a full report of the most recent examination certified by the chief regulatory official of another state with responsibility for the financial oversight of health maintenance organizations.
[PL 2021, c. 16, §13 (AMD).]
2. The Commissioner of Health and Human Services may make an examination concerning the quality of health care services of any health maintenance organization as often as the commissioner considers it necessary for the protection of the interests of the people of this State, but not less frequently than once every 3 years.
[RR 2021, c. 1, Pt. B, §346 (COR).]
3. Every health maintenance organization shall submit its books and records relating to health care services to such examinations and in every way facilitate them. For the purpose of examinations, the superintendent and the Commissioner of Health and Human Services may administer oaths to and examine the officers and agents of the health maintenance organization.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
4. The expenses of examinations under this section shall be assessed against the organization being examined and remitted to the superintendent or the Commissioner of Health and Human Services for whom the examination is being conducted.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
5. In lieu of such examination, the superintendent or Commissioner of Health and Human Services may accept the report of an examination made by persons holding comparable office of another state.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
SECTION HISTORY
PL 1975, c. 293, §4 (AMD). PL 1975, c. 503 (NEW). PL 2003, c. 689, §B7 (REV). PL 2021, c. 16, §13 (AMD). RR 2021, c. 1, Pt. B, §346 (COR).
Structure Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS
24-A §4202. Definitions (REPEALED)
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 §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-A. Continuity of health insurance coverage (REPEALED)
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 §4216. Suspension or revocation of certificate of authority
24-A §4217. Rehabilitation, liquidation or conservation of health maintenance organizations
24-A §4218-A. Compliance with the Affordable Care Act
24-A §4219. Administrative procedures
24-A §4221. Penalties and enforcement
24-A §4222. Statutory construction and relationship to other laws
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-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 §4249. Mandated offer of domestic partner benefits
24-A §4250. Coverage for hospice care services (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 §4257. Coverage for services provided by independent practice dental hygienist
24-A §4258. Coverage for children's early intervention services