LD 2105 – Maine

Status: Enacted
Year Introduced: 2020
Link: http://legislature.maine.gov/legis/bills/display_ps.asp?LD=2105&snum=129

An Act To Protect Consumers from Surprise Emergency Medical Bills. An out-of-network provider reimbursed for a surprise bill or a bill for covered emergency services under Title 24-A, section 4303-C , subsection 2, paragraph B or, if there is a dispute, under Title 24-A, section 4303-E may not bill an enrollee for health care services beyond the applicable coinsurance, copayment, deductible or other out-of-pocket cost expense that would be imposed for the health care services if the services were rendered by a network provider under the enrollee’s health plan. For an enrollee subject to coinsurance, the out-of-network provider shall calculate the coinsurance amount based on the median network rate for that health care service under the enrollee’s health plan. An out-of-network provider is also subject to the following with respect to any overpayment made by an enrollee. This bill requires the Department of Professional and Financial Regulation (DPFR), Bureau of Insurance, to develop an independent dispute resolution process for disputes regarding surprise medical bills.

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