| | 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 |
|
|