Maine Archives - Page 4 of 45 - The Source on HealthCare Price and Competition

11 08, 2023

LD 935

This bill requires that hospitals comply with the price transparency requirements established at 45 Code of Federal Regulations, Part 180, as in effect on January 1, 2023. It provides that upon application of the Attorney General, the Department of Health and Human Services or any affected patient, the Superior Court or District Court has full jurisdiction to enforce the price transparency laws. It prohibits a hospital from billing a patient, a patient guarantor or a 3rd-party payor for items or services provided to the patient, and requires that a hospital refund any payment made [...]

LD 935

11 08, 2023

LD 1085

This bill makes the following changes to the law relating to the comparable health care incentive program. 1. It removes the requirement that the small group health plan design be compatible with a health savings account. 2. It requires that the incentives be equal to or greater than 25% of the difference between the price of the service from the provider selected and the statewide average for the same covered health care service based on data reported on the publicly accessible health care costs website of the Maine Health Data Organization. 3. It adds [...]

LD 1085

11 08, 2023

LD 1105

This bill prohibits health care providers and health care practitioners from denying health care services or treatment based on the manner in which a patient intends to pay for health care services or treatment. The bill also requires health care providers and health care practitioners to disclose the cash price of health care services or treatments and allow a patient to pay cash instead of filing an insurance claim. The bill also prohibits a health insurance carrier from prohibiting a provider from providing an enrollee with the option of paying the provider's cash price [...]

LD 1105

11 08, 2023

LD 1143

This bill requires a hospital to issue a bill within one year of providing a service or the patient or guardian of the patient who received the service is not obligated to pay the bill.

LD 1143

11 08, 2023

LD 1165

This bill removes a provision that requires that compensation remitted by or on behalf of a pharmaceutical manufacturer, developer or labeler to a pharmacy benefits manager be remitted to the carrier if it is not remitted to the covered person. It retains the provision that requires that the compensation be remitted to the covered person to reduce the out-of pocket costs associated with a prescription drug. It requires pharmacy benefits managers to annually report compliance with this requirement to the Superintendent of Insurance. It authorizes the superintendent to impose civil penalties and take enforcement [...]

LD 1165

11 08, 2023

LD 1191

This bill provides that: 1. A health care practitioner or laboratory providing health care or laboratory services in a medical office or laboratory must inform patients of the cost of such care or services prior to provision of that care or those services; and 2. A health care entity may not bill a responsible party for the first time for a medical service that occurred more than one year earlier. It provides that a responsible party who receives a bill for a medical service for the first time for a medical service that occurred [...]

LD 1191

11 08, 2023

LD 1226

This bill requires the Department of Health and Human Services to notify a MaineCare 10 member 60 days prior to terminating benefits under the MaineCare program.

LD 1226

11 08, 2023

LD 1252

This bill limits the requirement for health insurance carriers to offer so-called clear choice design plans to individual health plans offered through the federally facilitated marketplace pursuant to the federal Patient Protection and Affordable Care Act or the Maine Health Insurance Marketplace. The bill also expands the ability of carriers to offer alternative plans to a clear choice design plan.

LD 1252

11 08, 2023

LD 1253

This bill removes the requirement that individual and small group health plans must be offered through a pooled market.

LD 1253

11 08, 2023

LD 1254

This bill allows a provider with a pending enrollment application to apply for a prior authorization of medications and services and requires the Department of Health and Human Services to make available prior authorization criteria to providers with a pending enrollment application. It also requires the Department of Health and Human Services to cover medications and services delivered by a provider during the time the provider's application is pending based on the determination of the prior authorization request.

LD 1254