Me. Stat. tit. 24-A, § 4304. Utilization review: Health Plan Requirements – Maine

Status: Enacted
Year Enacted: 1995
Year Amended: 2007
File: Download

Specifies requirements that carriers in the state must abide by if requiring pior authorization of health care services or otherwise subject payment of services to review for clinical necessity, appropriateness, efficacy or efficiency, including appointing a medical director to review and approve policies, responding to requests by providers for a prior authorization within 2 business days, requring the providers to submit background necessary to review the care, among others.


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