LD 1664
pg. 1
LD 1664 Title Page An Act to Clarify Basic Health Care Services to be Offered by Maine Health Main... Page 2 of 2
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LR 2426
Item 1

 
Emergency preamble. Whereas, Acts of the Legislature do not become
effective until 90 days after adjournment unless enacted as
emergencies; and

 
Whereas, this legislation is immediately necessary to ensure
that health maintenance organizations and employers are able to
vary particular coverages and copayment requirements to respond
to particular needs and market factors; and

 
Whereas, in the judgment of the Legislature, these facts create
an emergency within the meaning of the Constitution of Maine and
require the following legislation as immediately necessary for
the preservation of the public peace, health and safety; now,
therefore,

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 24-A MRSA §4202-A, sub-§1, as enacted by PL 1991, c. 709, §2,
is amended to read:

 
1. Basic health care services. "Basic health care services"
means health care services that an enrolled population might
reasonably require in order to be maintained in good health,
including includes, at a minimum, emergency care, inpatient
hospital care, inpatient-outpatient inpatient physician services,
outpatient physician services, x-ray services and, laboratory
services and all statutorily mandated benefits and benefits
mandated by rule applicable to health maintenance organizations.
The Bureau of Insurance may adopt rules defining "basic health
care services" to be provided by health maintenance
organizations.__In adopting any such rules, the Bureau of
Insurance shall consider the coverages that have traditionally
been provided by health maintenance organizations, the need for
flexibility in the marketplace and the importance of providing
multiple options to employers and consumers.__Rules adopted under
this subsection are routine technical rules pursuant to Title 5,
chapter 375, subchapter II-A.

 
Sec. 2. 24-A MRSA §4204, sub-§2-A, ļO is enacted to read:

 
O.__Each health maintenance organization shall provide basic
health care services.__The Bureau of Insurance may not require
that all health benefit plans offered by health maintenance
organizations meet or exceed the requirements of standard or
basic health plans specified in the Bureau of Insurance Rule,
Chapter 750.__Health maintenance organizations may vary the
coverages set forth in particular health benefit plans and the
copayments and related limitations governing number of visits and
dollar copayments, so long as each such health benefit plan


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