2010 Maine Code
TITLE 24: INSURANCE
Chapter 19: NONPROFIT HOSPITAL OR MEDICAL SERVICE ORGANIZATIONS
24 §2345. Enforcement

Subchapter 2-A: LICENSURE OF MEDICAL UTILIZATION REVIEW ENTITIES HEADING: PL 1989, C. 556, PT. C, §1 (NEW)

§2345. Enforcement

The following provisions govern enforcement of this chapter. [1989, c. 556, Pt. C, §1 (NEW).]

1. Periodic reviews. The superintendent may conduct periodic reviews of the operations of the entities licensed pursuant to this subchapter to ensure that they continue to meet the minimum standards set forth in section 2343 and any applicable rules adopted by the superintendent. The superintendent may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required by section 2343.

[ 1989, c. 556, Pt. C, §1 (NEW) .]

2. Action against licensee. The superintendent is authorized to take appropriate action against a licensee which fails to meet the standards of this subchapter or any rules adopted by the superintendent, or who fails to respond in a timely manner to corrective actions ordered by the superintendent. The superintendent may impose a civil penalty not to exceed $1,000 for each violation, as permitted by Title 24-A, section 12-A or may deny, suspend or revoke the license.

[ 1989, c. 556, Pt. C, §1 (NEW) .]

3. Opportunity to provide information and request hearing. Before taking the actions authorized by this section to deny, suspend or revoke the license, the superintendent shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this subchapter and the opportunity to request a hearing to be held consistent with the provisions of the Maine Administrative Procedure Act, Title 5, chapter 375.

[ 1989, c. 556, Pt. C, §1 (NEW) .]

4. Authority to adopt rules. The superintendent may adopt rules necessary to implement the provisions of this subchapter.

[ 1989, c. 556, Pt. C, §1 (NEW) .]

5. Rulings on appropriateness of medical judgments not authorized. Nothing in this subchapter requires or authorizes the superintendent to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents.

[ 1989, c. 556, Pt. C, §1 (NEW) .]

SECTION HISTORY

1989, c. 556, §C1 (NEW).