Maine § 24-A §4304-A Prior authorization for rehabilitative or habilitative services

Maine Statutes

§ 24-A §4304-A — Prior authorization for rehabilitative or habilitative services

Maine § 24-A §4304-A

Title 24-AMAINE INSURANCE CODE

Ch. 56-AHEALTH PLAN IMPROVEMENT ACT

This text of Maine § 24-A §4304-A (Prior authorization for rehabilitative or habilitative services) 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 §4304-A (2026).

Text

1.Prior authorization for new episode of care prohibited for 12 visits. A carrier may not require prior authorization for rehabilitative or habilitative services, including, but not limited to, physical therapy services, occupational therapy services or chiropractic services, for the first 12 visits of each new episode of care. For purposes of this subsection, "new episode of care" means treatment for a new condition or treatment for a recurring condition for which an enrollee has not been treated within the previous 90 days.

2.Intent. This section does not limit the right of a carrier to deny a claim when an appropriate prospective or retrospective review concludes that the health care services or treatment rendered were not medically necessary.

Free access — add to your briefcase to read the full text and ask questions with AI

1.
Prior authorization for new episode of care prohibited for 12 visits.
A carrier may not require prior authorization for rehabilitative or habilitative services, including, but not limited to, physical therapy services, occupational therapy services or chiropractic services, for the first 12 visits of each new episode of care. For purposes of this subsection, "new episode of care" means treatment for a new condition or treatment for a recurring condition for which an enrollee has not been treated within the previous 90 days.
2.
Intent.
This section does not limit the right of a carrier to deny a claim when an appropriate prospective or retrospective review concludes that the health care services or treatment rendered were not medically necessary.