Sec. 1. 24-A MRSA §4205, sub-§1, śC, as enacted by PL 1975, c. 503, is amended to read:

C. The furnishing of health care services through providers which that are under contract with or employed by the health maintenance organization.__A health maintenance organization may furnish health care services through providers that exceed the standard geographic accessibility limits imposed by the bureau for primary care, specialty care and hospital services if the provider is a center of excellence;

Sec. 2. Rulemaking. Pursuant to the rule-making authority under the Maine Revised Statutes, Title 24-A, section 4222-A, the Superintendent of Insurance shall define "center of excellence" for purposes of section 4205, subsection 1, paragraph C.

SUMMARY

This bill overrides current Department of Professional and Financial Regulation, Bureau of Insurance rules that restrict travel distances for obtaining health care by allowing patients enrolled in health maintenance organizations to seek appropriate care in centers of excellence outside of the standard travel area. The bill also requires that the Superintendent of Insurance define "center of excellence" under rule-making authority that already exists under statutes.