HEALTH PLAN REQUIREMENTS

  1. Law
  2. Maine Revised Statutes
  3. MAINE INSURANCE CODE
  4. HEALTH PLAN IMPROVEMENT ACT
  5. HEALTH PLAN REQUIREMENTS

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Section
24-A §4301

Definitions (REPEALED)

Section
24-A §4301-A

Definitions

Section
24-A §4302

Reporting requirements

Section
24-A §4303

Plan requirements

Section
24-A §4303-A

Provider profiling programs

Section
24-A §4303-B

Disclosure related to provider networks

Section
24-A §4303-C

Protection from surprise bills and bills for out-of-network emergency services

Section
24-A §4303-D

Provider directories

Section
24-A §4303-E

Dispute resolution process for surprise bills and bills for out-of-network emergency services

Section
24-A §4303-F

Reimbursement for ambulance services and participation of ambulance service providers in carrier networks

Section
24-A §4304

Utilization review

Section
24-A §4305

Quality of care

Section
24-A §4306

Enrollee choice of primary care provider

Section
24-A §4306-A

Patient access to obstetrical and gynecological care

Section
24-A §4307

Construction

Section
24-A §4308

Indemnification

Section
24-A §4309

Adoption of rules

Section
24-A §4309-A

Compliance with the Affordable Care Act

Section
24-A §4310

Access to clinical trials

Section
24-A §4311

Access to prescription drugs

Section
24-A §4312

Independent external review

Section
24-A §4313

Carrier liability; cause of action

Section
24-A §4314

Access to eye care providers

Section
24-A §4314-A

Coverage for early refills of prescription eye drops

Section
24-A §4315

Coverage of prosthetic devices

Section
24-A §4316

Coverage for telehealth services

Section
24-A §4317

Pharmacy providers

Section
24-A §4317-A

Prescription drug coverage; out-of-pocket expenses for coinsurance

Section
24-A §4317-B

Orally administered cancer therapy

Section
24-A §4317-C

Coverage for prescription insulin drugs; limit on out-of-pocket costs

Section
24-A §4317-D

Coverage of HIV prevention drugs

Section
24-A §4318

Prohibition against maximum aggregate benefit provisions (REALLOCATED FROM TITLE 24-A, SECTION 4317) (REPEALED)

Section
24-A §4318-A

Comparable health care service incentive program (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

Section
24-A §4318-B

Access to lower-priced services (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/1/24) (WHOLE SECTION TEXT REPEALED 1/1/24)

Section
24-A §4319

Rebates

Section
24-A §4319-A

Guaranteed issue

Section
24-A §4320

No lifetime or annual limits on health plans

Section
24-A §4320-A

Coverage of preventive and primary health services

Section
24-A §4320-B

Extension of dependent coverage

Section
24-A §4320-C

Emergency services

Section
24-A §4320-D

Comprehensive health coverage

Section
24-A §4320-E

Reinsurance, risk corridors and risk adjustment

Section
24-A §4320-F

Oversight of plans offered on the American Health Benefit Exchange and the SHOP Exchange

Section
24-A §4320-G

Applicability to health plans grandfathered under the Affordable Care Act

Section
24-A §4320-H

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

Section
24-A §4320-I

Coverage for the cost of testing for bone marrow donation suitability

Section
24-A §4320-J

Coverage for abuse-deterrent opioid analgesic drug products

Section
24-A §4320-K

Coverage for services provided by a naturopathic doctor

Section
24-A §4320-L

Nondiscrimination

Section
24-A §4320-M

Coverage for abortion services

Section
24-A §4320-N

Step therapy (REALLOCATED FROM TITLE 24-A, SECTION 4320-M)

Section
24-A §4320-O

Coverage for services provided by a physician assistant

Section
24-A §4320-P

Coverage for health care services for COVID-19

Section
24-A §4320-Q

Coverage for services provided by a certified registered nurse anesthetist (REALLOCATED FROM TITLE 24-A, SECTION 4320-P)