LD 743
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LD 743 Title Page An Act To Streamline the Appeals Process for the Determination of Certain Healt... LD 743 Title Page
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LR 1476
Item 1

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

 
Sec. 1. 24 MRSA §2317-B, sub-§10, as amended by PL 2001, c. 258, Pt.
G, §1, is repealed.

 
Sec. 2. 24-A MRSA §2747, as amended by PL 2003, c. 428, Pt. H, §4,
is repealed.

 
Sec. 3. 24-A MRSA §2816, as amended by PL 1981, c. 698, §110, is
further amended to read:

 
§2816. Requirements

 
No policy of group or blanket health insurance shall may,
except as provided in section 2829, be delivered or issued for
delivery in this State, unless the policy contains in substance
each and all of the provisions set forth in sections 2817 to
2828, or provisions which that in the opinion of the
superintendent are more favorable to the holders of such
certificates or not less favorable to the holders of such
certificates and more favorable to policyholders. Insurers
offering policies under this chapter shall offer to certificate
holders the right of review and arbitration set forth in section
2747, subsection 1, with respect to denials of medical expense
reimbursement benefits based upon the grounds set forth in
section 2747, subsection 2, except that the requirement of
section 2747, subsection 1 shall not apply to certificate holders
in groups subject to the United States Employee Retirement Income
Security Act of 1974, Public Law 93-406, as amended, or to any
policy or certificate holder to whom the insurer voluntarily
extends a review similar to that which it provides to persons
insured under group policies subject to that Act.

 
SUMMARY

 
This bill eliminates the requirement that health insurance
carriers offer members in the nongroup market nonbinding
arbitration for the determination of certain benefits.


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