Sec. 1. 24-A MRSA §2185-A is enacted to read:

§2185-A.__Provider payments and controverted claims

1.__Definitions.__As used in this section, unless the context otherwise indicates, the following terms have the following meanings.

A.__"Health care provider" has the same meaning set forth in section 2204, subsection 13.

B.__"Insured" means a person covered for health care services provided to that person under an insurance policy, health maintenance organization plan or subscriber contract or certificate of a nonprofit hospital or medical service organization.

C.__"Insurer" means any insurance company, health maintenance organization or nonprofit hospital or medical service organization authorized to issue health care policies, plans, contracts or certificates in this State.

2.__Provider payments.__Except as provided in subsection 3, an insurer shall pay a health care provider for health care services provided to an insured within 30 days of receipt by the insurer of a claim for the services from the health care provider or insured.

3.__Controverted claim.__If the insurer controverts a claim submitted by a health care provider or insured, the insurer shall notify the health care provider and insured in writing that the claim is controverted.__Health care services within the scope of the controverted claim provided to the insured by the health care provider after the provider receives the notice required by this subsection are not subject to the 30-day payment requirement of subsection 2.

4.__Expenses related to controverted claim.__If the insurer, any other entity pursuant to agreement by the insurer and insured or a court determines that the insurer is obligated to pay a controverted claim, the insurer shall pay in addition to the claim amount for:

A.__Legal expenses incurred by the insured in pursuit of payment of the controverted claim; and