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| | | An Act To Prohibit Absolute Discretion Clauses in Health |
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| | | Be it enacted by the People of the State of Maine as follows: |
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| | | Sec. 1. 24-A MRSA §4303, sub-§9 is enacted to read: |
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| | | 9.__Absolute discretion clauses.__The use and enforcement of | | an absolute discretion clause is governed by this subsection. |
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| | | A.__A policy, contract, certificate or agreement offered, | | delivered, issued or renewed for delivery in this State by a | | carrier to provide, deliver, arrange for, pay for or | | reimburse any of the costs of health care services may not | | contain a provision purporting to reserve sole or absolute | | discretion to the carrier to interpret the terms of the | | contract or to provide standards of interpretation or review | | that are inconsistent with the laws of this State. |
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| | | B.__A carrier may not enforce a provision in a policy, contract, | | certificate or agreement that was offered, delivered or issued for | | delivery in this State and has been continued or renewed by a group | | policy holder or individual enrollee in this State that purports to | | reserve sole or absolute discretion to the carrier to interpret the terms | | of the contract or to provide standards of interpretation or review that | | are inconsistent with the laws of this State. |
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