| | | Emergency preamble. Whereas, Acts of the Legislature do not become | | effective until 90 days after adjournment unless enacted as | | emergencies; and |
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| | | 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 |
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| | | 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, |
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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 §4202-A, sub-§1, as enacted by PL 1991, c. 709, §2, | | is amended to read: |
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| | | 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. |
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| | | Sec. 2. 24-A MRSA §4204, sub-§2-A, ļO is enacted to read: |
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| | | 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 |
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