Me. Stat. tit. 24-A, § 2749-B. Penalty for noncompliance with utilization review programs: Health Insurance Contracts – Maine

Status: Enacted
Year Enacted: 1993
Year Amended: 1995
File: Download

States that “ A health insurance policy issued or renewed in this State after April 8, 1994 may not contain a provision that permits, upon retroactive review and confirmation of medical necessity, the imposition of a penalty of more than $500 for failure to provide notification under a utilization review program. This section does not limit the right of insurers to denya claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary.“


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