Maine Revised Statutes
Chapter 56: HEALTH MAINTENANCE ORGANIZATIONS
24-A §4221. Penalties and enforcement

§4221. Penalties and enforcement
1.  The superintendent may levy an administrative penalty in an amount not less than $100 nor more than $500, if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time within which to remedy the defect in its operations that gave rise to the penalty citation. The superintendent may augment this penalty by an amount equal to the sum that the superintendent calculates to be the damages suffered by enrollees or other members of the public.  
[RR 2021, c. 1, Pt. B, §349 (COR).]
2.  If the superintendent or the Commissioner of Health and Human Services shall for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the superintendent or Commissioner of Health and Human Services may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation.  
Proceedings under this subsection shall not be governed by any formal procedural requirements and may be conducted in such manner as the superintendent or the Commissioner of Health and Human Services may deem appropriate under the circumstances.  
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
3.  The superintendent may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of this chapter.  
Within 10 days after service of the order of cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred.  
[PL 1975, c. 503 (NEW).]
4.  In the case of any violation under this chapter, if the superintendent elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to this section, the superintendent may apply to the Superior Court to issue an injunction restraining the company in whole or in part from proceeding further with its business, or the superintendent may apply for an order of the court to command performance consistent with contractual obligations of the health maintenance organization.  
[RR 2021, c. 1, Pt. B, §350 (COR).]
SECTION HISTORY
PL 1975, c. 293, §5 (AMD). PL 1975, c. 503 (NEW). PL 1977, c. 694, §437 (AMD). PL 2003, c. 689, §B7 (REV). RR 2021, c. 1, Pt. B, §§349, 350 (COR).

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