HP0215, LD 291, item 2, ‘An Act Regarding Responsibility for the Duplicative or Incorrect Payment of Health Insurance Claims’

Amend the bill by striking out the title and substituting the following:

‘An Act Regarding Responsibility for the Duplicative or Incorrect Payment of Health Insurance Claims’

Amend the bill by striking out everything after the enacting clause and inserting the following:

‘Sec. 1. 24-A MRSA §4303, sub-§23 is enacted to read:

23. Duplicative or incorrect claims payments. If a carrier has made a duplicative or incorrect payment on a claim with respect to a health plan:

A. If the claim payment was made to a provider, the carrier shall retroactively seek collection related to that payment directly from the provider; and

B. The carrier may not attempt to retroactively seek collection related to the claim payment from an enrollee unless the enrollee was already paid directly for the services identified in the claim and a provider submits evidence to the carrier that the enrollee did not forward payment to the provider. After a provider has submitted evidence that the enrollee did not forward payment to the provider, a carrier may require an enrollee to provide evidence of payment to the provider.’

Amend the bill by relettering or renumbering any nonconsecutive Part letter or section number to read consecutively.

summary

This amendment replaces the bill and changes the title. It clarifies that the provisions of the bill are intended to apply to duplicative or incorrect claims payments made with respect to health insurance coverage.

HP0215 LD 291	Session - 129th Maine Legislature C "A", Filing Number H-17, Sponsored by		LR 1272 Item 2
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