2010 Maine Code
TITLE 24: INSURANCE
Chapter 19: NONPROFIT HOSPITAL OR MEDICAL SERVICE ORGANIZATIONS
24 §2302-C. Penalty for noncompliance with utilization review programs
Subchapter 1: GENERAL PROVISIONS
§2302-C. Penalty for noncompliance with utilization review programs
A contract issued or renewed by a nonprofit service organization 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 nonprofit service organizations to deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary. [1995, c. 332, Pt. M, §2 (NEW).]
SECTION HISTORY
1995, c. 332, §M2 (NEW).
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