§4222-B. Applicability
1. Every health maintenance organization licensed under this chapter is considered an insurer for purposes of those provisions of the insurance laws that do not expressly reference health maintenance organizations, but are applicable to health maintenance organizations under this chapter.
[PL 1995, c. 332, Pt. O, §8 (NEW).]
2. The requirements of chapter 36, continuity of health insurance coverage law, apply to health maintenance organizations.
[PL 1995, c. 332, Pt. O, §8 (NEW).]
3. The requirements of sections 2736‑C and 2808‑B, community rating law, apply to health maintenance organizations, except that a health maintenance organization is not required to offer coverage or accept applications from an eligible group or individual located outside the health maintenance organization's approved service area.
[PL 1995, c. 332, Pt. O, §8 (NEW).]
4. The requirements of chapter 23 and any rules adopted pursuant to it, to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to health maintenance organizations.
[PL 1995, c. 332, Pt. O, §8 (NEW).]
5. The requirements of sections 221 to 228, to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to domestic health maintenance organizations.
[PL 2017, c. 169, Pt. A, §12 (AMD).]
6. The requirements of chapter 57, subchapters I and II apply to health maintenance organizations.
[PL 2001, c. 88, §6 (AMD).]
7. The requirements of section 421 apply to health maintenance organizations.
[PL 1997, c. 457, §50 (AMD).]
8. The requirements of chapter 32, the Preferred Provider Arrangement Act of 1986, apply to health maintenance organizations only with respect to activities that are not otherwise authorized by chapter 56.
[PL 1995, c. 332, Pt. O, §8 (NEW).]
9. The requirements of chapter 56‑A and any rules adopted pursuant to that chapter apply to health maintenance organizations.
[PL 1995, c. 673, Pt. D, §7 (NEW).]
10. The requirements of section 237 apply to health maintenance organizations, including those operated and organized as a division or line of business of a nonprofit hospital, medical or health care service organization.
[PL 1997, c. 79, §3 (NEW).]
11. The requirements of sections 2834 and 2834‑B apply to health maintenance organizations.
[PL 1997, c. 445, §31 (NEW); PL 1997, c. 445, §32 (AFF).]
12. The requirements of chapter 24 and any rules adopted pursuant to that chapter apply to health maintenance organizations.
[PL 1997, c. 677, §4 (NEW).]
13. The requirements of sections 2436 and 2436‑A apply to health maintenance organizations.
[PL 1999, c. 256, Pt. F, §1 (NEW).]
14. The requirement of filing a report of experience of claims payment for substance use disorder treatment in the format prescribed by section 2842, subsection 9; for chiropractic services in the format prescribed by section 2748, subsection 3 and section 2840‑A, subsection 3; and for breast cancer screening services in the format prescribed by section 2745‑A, subsection 4 and section 2837‑A, subsection 4 applies to health maintenance organizations.
[PL 2017, c. 407, Pt. A, §97 (AMD).]
15. The requirements of section 415‑A apply to health maintenance organizations.
[PL 2001, c. 88, §7 (NEW).]
15. (REALLOCATED TO T. 24-A, §4222-B, sub-§20)
[RR 2001, c. 1, §35 (RAL).]
16. The requirements of sections 3483 and 3484 apply to health maintenance organizations.
[PL 2001, c. 88, §7 (NEW).]
17. Section 2803‑A, relating to disclosure of loss information, applies to health maintenance organizations.
[PL 2001, c. 410, Pt. B, §3 (NEW).]
18. The requirement of section 2809‑A, subsection 11 to continue group coverage under certain circumstances applies to health maintenance organizations.
[PL 2001, c. 410, Pt. B, §3 (NEW).]
19. Section 12‑A, relating to penalties, applies to health maintenance organizations.
[PL 2001, c. 410, Pt. B, §3 (NEW).]
20. (REALLOCATED FROM T. 24-A, §4222-B, sub-§15) Sections 2735‑A and 2839‑A, relating to notice of rate filings and rate increases, apply to health maintenance organizations.
[RR 2001, c. 1, §35 (RAL).]
21. Section 2723‑A, subsection 3 and section 2844, subsection 3 apply to health maintenance organizations.
[PL 2005, c. 121, Pt. D, §4 (NEW).]
22. Sections 2713‑A and 2823‑A, relating to explanation and notice to parents, apply to health maintenance organizations.
[PL 2009, c. 244, Pt. B, §3 (NEW).]
23. Section 423‑C, relating to reporting of material investment and reinsurance transactions, applies to health maintenance organizations.
[PL 2017, c. 169, Pt. A, §13 (NEW).]
24. Section 423‑G, relating to corporate governance annual disclosure filings, applies to health maintenance organizations.
[PL 2017, c. 169, Pt. A, §13 (NEW).]
SECTION HISTORY
PL 1995, c. 332, §O8 (NEW). PL 1995, c. 673, §D7 (AMD). PL 1997, c. 79, §3 (AMD). PL 1997, c. 445, §31 (AMD). PL 1997, c. 445, §32 (AFF). PL 1997, c. 457, §50 (AMD). PL 1997, c. 677, §4 (AMD). PL 1999, c. 256, §F1 (AMD). RR 2001, c. 1, §35 (COR). PL 2001, c. 88, §§6,7 (AMD). PL 2001, c. 258, §G3 (AMD). PL 2001, c. 410, §B3 (AMD). PL 2001, c. 432, §8 (AMD). PL 2005, c. 121, §D4 (AMD). PL 2009, c. 244, Pt. B, §3 (AMD). PL 2017, c. 169, Pt. A, §§12, 13 (AMD). PL 2017, c. 407, Pt. A, §97 (AMD).
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