Me. Stat. tit. 24-A, § 4305. Quality of Care: Health Plan Requirements – Maine
Status: EnactedYear Enacted: 1995
Year Amended: 2007
File: Download
States that a carrier that subjects payment of benefits to review for clinical necessity, appropriateness, efficacy or efficiency must have an ongoing quality assurance program, must describe the standards of quality of care in a written document, and not deny payment for services based on an enrollees age, nature of disability or degree of medical dependency.
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