LD 1284
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LD 1284 Title Page An Act Related to the Financial Regulation of Health Maintenance Organizations ... Page 2 of 2
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LR 742
Item 1

 
Be it enacted by the People of the State of Maine as follows:

 
Sec. 1. 24-A MRSA §4204, sub-§4, ¶F is enacted to read:

 
F.__The superintendent may require a health maintenance
organization to continue to maintain the deposit required
under this subsection after the health maintenance
organization has withdrawn from the market in accordance
with section 415-A.

 
Sec. 2. 24-A MRSA §4204, sub-§6, ¶C is enacted to read:

 
C.__In addition to the other provisions in this subsection,
if a petition to liquidate an insolvent health maintenance
organization is filed with a court of competent
jurisdiction, then after the date of filing the petition for
liquidation:

 
(1)__Any provider who has rendered a covered service
for a subscriber or enrollee of the insolvent health
maintenance organization is prohibited from collecting
or attempting to collect from the subscriber or
enrollee amounts normally payable by the insolvent
health maintenance organization; and

 
(2)__A provider or agent, trustee or assignee of the
provider may not maintain any action at law against a
subscriber or enrollee of the insolvent health
maintenance organization to collect amounts for covered
services normally payable by the insolvent health
maintenance organization.

 
Nothing in this subsection prohibits a provider from
collecting or attempting to collect from a subscriber or
enrollee any amounts for services not normally payable by
the insolvent health maintenance organization, including
applicable copayments or deductibles.

 
Sec. 3. 24-A MRSA §4204-A, sub-§2, ¶C, as enacted by PL 1989, c. 842,
§14, is amended to read:

 
C. An amount equal to the sum of 3 months uncovered health
care expenditures as reported on the financial statement
covering the health maintenance organization's immediately
preceding fiscal year as filed with the superintendent; or

 
Sec. 4. 24-A MRSA §4204-A, sub-§2, ¶D, as enacted by PL 1989, c. 842,
§14, is repealed and the following enacted in its place:


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