LD 1611
pg. 53
Page 52 of 73 PUBLIC Law Chapter 469 Page 54 of 73
Download Chapter Text
LR 2137
Item 1

 
standardized claim form for professional or facility services, as
applicable, approved by the Federal Government and submitted
electronically. An insurer may not be required to accept a claim
submitted on a form other than the applicable form specified in
this section and may not be required to accept a claim that is not
submitted electronically, except from a health care practitioner
who is exempt pursuant to Title 24, section 2985.

 
Sec. D-8. 24-A MRSA §4235, as amended by PL 2003, c. 218, §8, is
further amended to read:

 
§4235. Standardized claim forms

 
All health maintenance organizations providing payment or
reimbursement for diagnosis or treatment of a condition or a
complaint by a licensed physician or chiropractor health care
practitioner must accept the current standardized claim form for
professional services approved by the Federal Government and
submitted electronically. All health maintenance organizations
providing payment or reimbursement for diagnosis or treatment of
a condition or a complaint by a licensed hospital must accept the
current standardized claim form for professional or facility
services, as applicable, approved by the Federal Government and
submitted electronically. A health maintenance organization may
not be required to accept a claim submitted on a form other than
the applicable form specified in this section and may not be
required to accept a claim that is not submitted electronically,
except from a health care practitioner who is exempt pursuant to
Title 24, section 2985.

 
Sec. D-9. Effective date. This Part takes effect October 16, 2003.

 
PART E

 
Sec. E-1. 24 MRSA §2327, as amended by PL 2003, c. 428, Pt. E, §1,
is further amended to read:

 
§2327. Group rates

 
A group health care contract may not be issued by a nonprofit
hospital or medical service organization in this State until a
copy of the group rates to be used in calculating the premium for
these contracts has been filed for informational purposes with
the superintendent. The filing must include the base rates and a
description of any procedures to be used to adjust the base rates
to reflect factors including but not limited to age, gender,
health status, claims experience, group size and coverage of
dependents.
Notwithstanding this section,


Page 52 of 73 Top of Page Page 54 of 73
Related Pages
  Search Bill Text Legislative Information
Bill Directory Search
Bill
Status
Session Information
119th Legislature Bills Maine Legislature

Office of Legislative Information
100 State House Station
Augusta, ME 04333
voice: (207) 287-1692
fax: (207) 287-1580
tty: (207) 287-6826
Word Viewer for Windows Disclaimer