Sec. 13. 24-A MRSA §4303, sub-§3, as enacted by PL 1995, c. 673, Pt. C, §1 and affected by §2, is amended to read:

3. Provider's right to advocate for medically appropriate care. A carrier offering a managed care plan may not terminate or otherwise discipline a participating provider because the provider advocates for medically appropriate health care. A carrier may not restrict a provider from disclosing to any enrollee any information the provider determines appropriate regarding the nature of treatment and any risks or alternatives to treatment, financial incentives that may affect the treatment of the patient, the availability of other therapy, consultations or tests or the decision of any plan to authorize or deny health care services or benefits.

A. For the purposes of this section, "to advocate for medically appropriate health care" means to discuss or recommend a course of treatment to an enrollee; to appeal a managed care plan's decision to deny payment for a service pursuant to an established grievance or appeal procedure; or to protest a decision, policy or practice that the provider, consistent with the degree of learning and skill ordinarily possessed by reputable providers, reasonably believes impairs the provider's ability to provide medically appropriate health care to the provider's patients.

B. Nothing in this subsection may be construed to prohibit a plan from making a determination not to pay for a particular medical treatment or service or to enforce reasonable peer review or utilization review protocols.

Sec. 14. 24-A MRSA §4303, sub-3-B is enacted to read:

3-B.__Prohibition of contingent compensation arrangements.__A carrier may not permit or provide compensation or anything of value to its employees, agents, contractors or participating providers in a manner that is based, directly or indirectly, on the quantity or type of adverse determinations rendered.

Sec. 15. 24-A MRSA §4303, sub-§4, ¶¶ C and D are enacted to read:

C.__Grievances and appeals may be communicated orally by the enrollee or the enrollee's designee.

D.__If the carrier fails to comply with any of the deadlines for completion of grievances or appeals or if the carrier