Maine Revised Statutes

Title 24-A, Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT

Subchapter 1: HEALTH PLAN REQUIREMENTS

24-A §4301. Definitions (REPEALED)

24-A §4301-A. Definitions

24-A §4302. Reporting requirements

24-A §4303. Plan requirements

24-A §4304. Utilization review

24-A §4305. Quality of care

24-A §4306. Enrollee choice of primary care provider

24-A §4306-A. Patient access to obstetrical and gynecological care

24-A §4307. Construction

24-A §4308. Indemnification

24-A §4309. Adoption of rules

24-A §4309-A. Compliance with the Affordable Care Act

24-A §4310. Access to clinical trials

24-A §4311. Access to prescription drugs

24-A §4312. Independent external review

24-A §4313. Carrier liability; cause of action

24-A §4314. Access to eye care providers

24-A §4315. Coverage of prosthetic devices

24-A §4316. Coverage for telemedicine services

24-A §4317. Pharmacy providers

24-A §4317-A. Prescription drug coverage; out-of-pocket expenses for coinsurance

24-A §4318. Prohibition against maximum aggregate benefit provisions (REALLOCATED FROM TITLE 24-A, SECTION 4317)

24-A §4319. Rebates

24-A §4320. No lifetime or annual limits on health plans subject to the Affordable Care Act

24-A §4320-A. Coverage of preventive health services

24-A §4320-B. Extension of dependent coverage

24-A §4320-C. Emergency services

24-A §4320-D. Comprehensive health coverage

24-A §4320-E. Reinsurance, risk corridors and risk adjustment

24-A §4320-F. Oversight of plans offered on the American Health Benefit Exchange and the SHOP Exchange

24-A §4320-G. Applicability to health plans grandfathered under the Affordable Care Act

24-A §4320-H. Payment reform pilot projects (REALLOCATED FROM TITLE 24-A, SECTION 4320)

Subchapter 2: CONSUMER HEALTH CARE DIVISION

24-A §4321. Consumer Health Care Division

24-A §4322. Consumer Health Care Division Advisory Council (REPEALED)

Subchapter 3: DOWNSTREAM RISK

24-A §4331. Definitions

24-A §4332. Safe harbor and waiver

24-A §4333. Requirements for downstream risk arrangements

24-A §4334. Substantial insurance risk; substantial enrollment risk

24-A §4335. Contractual provisions

24-A §4336. Disclosure requirements for organizations with downstream risk arrangements

24-A §4337. Requirements related to subcontracting arrangements

24-A §4338. Downstream risk arrangements that exceed risk threshold described in section 4334

24-A §4339. Contractual provisions to demonstrate financial viability

24-A §4340. Financial viability

24-A §4341. Limitations on premium transfer

24-A §4342. Related provisions

24-A §4343. Rules