Maine § 24-A §4228 Utilization review data

Maine Statutes

§ 24-A §4228 — Utilization review data

Maine § 24-A §4228

Title 24-AMAINE INSURANCE CODE

Ch. 56HEALTH MAINTENANCE ORGANIZATIONS

This text of Maine § 24-A §4228 (Utilization review data) is published on Counsel Stack Legal Research, covering Maine primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Me. Rev. Stat. tit. 24-A, § 24-A §4228 (2026).

Text

1.Report required. On or before April 1st of each year, each health maintenance organization which issues a program of contract in this State that contains a provision whereby in nonemergency cases the insured is required to be prospectively evaluated through a prehospital admission certification, preinpatient service eligibility program or any similar preutilization review or screening procedure prior to the delivery of contemplated hospitalization, inpatient or outpatient health care or medical services which are prescribed or ordered by a duly licensed physician shall file a report on the results of that evaluation for the preceding year with the superintendent which shall contain the following:

2.Maine residents. This section is applicable to evaluations, appeals and complaints relat

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1.
Report required.
On or before April 1st of each year, each health maintenance organization which issues a program of contract in this State that contains a provision whereby in nonemergency cases the insured is required to be prospectively evaluated through a prehospital admission certification, preinpatient service eligibility program or any similar preutilization review or screening procedure prior to the delivery of contemplated hospitalization, inpatient or outpatient health care or medical services which are prescribed or ordered by a duly licensed physician shall file a report on the results of that evaluation for the preceding year with the superintendent which shall contain the following:
2.
Maine residents.
This section is applicable to evaluations, appeals and complaints relating to Maine residents only.
3.
Confidentiality.
Any information provided pursuant to this section shall not identify the names of patients.