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2011 Maine Revised Statutes
TITLE 24-A: MAINE INSURANCE CODE
Chapter 35: GROUP AND BLANKET HEALTH INSURANCE
24-A §2847-D. Penalty for noncompliance with utilization review programs


24-A ME Rev Stat § 2847-D (2011 through 125th Legis) What's This?

§2847-D. Penalty for noncompliance with utilization review programs

A policy or certificate issued or renewed 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 deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary. [1995, c. 332, Pt. M, §9 (AMD).]

SECTION HISTORY

1993, c. 645, §B5 (NEW). 1995, c. 332, §M9 (AMD).

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