Me. Stat. tit. 24-A, §§ 2847 & 2847-D. Utilization review data: Group or Blanket Health Insurance Law – Maine

Status: Enacted
Year Enacted: 1989
Year Amended: 1995
File: Download

On or before April 1st of each year, any insurer or 3rd-party administrator which issues or administers a program or contract in this State providing coverage for hospital care that contains a provision whereby in nonemergency cases the insured is required to be prospectively evaluated through a prehospital admission certification, preinpatient service eligibility program or any similar preutilization review or screening eligibility program or any similar preutilization review or screening procedure prior to the delivery of contemplated hospitalization, inpatient or outpatient health care or medical services which are prescribed or ordered by a duly licensed physician shall file a report on the results of that evaluation for the preceding year with the superintendent.


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