Maine LD 704: An Act Regarding Notice Provided by Insurance Carriers to Health Care Providers

LD 704 (subjects: INSURANCE , HEALTH )

Official bill page at mainelegislature.org: http://www.mainelegislature.org/legis/bills/display_ps.asp?ld=704&PID=1456&snum=127


Sponsors | Actions | Bill Text | Patterns of Support


Sponsors

Principal Sponsor: Rep. Henry Beck of Waterville: (D – District 110) — e-mail | Twitter | Facebook

1 Cosponsors:

Actions

Chamber

Action
3/5/2015 House Committee on Insurance and Financial Services suggested and ordered printed.
The Bill was REFERRED to the Committee on INSURANCE AND FINANCIAL SERVICES.
Sent for concurrence. ORDERED SENT FORTHWITH.
3/11/2015 Senate On motion by Senator MASON of Androscoggin , REFERRED to the Committee on Insurance and Financial Services, in concurrence.
6/30/2015 Senate CARRIED OVER to any Special or Regular Session of the 127th Legislature pursuant to Joint Order HP 992. in concurrence
6/30/2015 House Carried over to any special and/or regular session of the 127th Legislature pursuant to Joint Order HP 992.
6/30/2015 Senate CARRIED OVER to any Special or Regular Session of the 127th Legislature pursuant to Joint Order HP 992. , in concurrence.
1/28/2016 Senate Pursuant to Joint Rule 310.3 Placed in Legislative Files (DEAD)

Bill Text

.

An Act Regarding Notice Provided by Insurance Carriers to Health Care Providers

Be it enacted by the People of the State of Maine as follows:

Sec. 1. 24-A MRSA 4320-J is enacted to read:

4320-J. Notice of grace period

If an enrollee is covered by an insurance product purchased through the American Health Benefit Exchange pursuant to the federal Affordable Care Act and is in the 3-month grace period under 45 Code of Federal Regulations, Section 156.270(d)(2015) and a provider, or a representative of a provider, requests information from a carrier regarding the enrollee’s eligibility, coverage or health plan benefits or the status of a claim or claims for services provided to the enrollee and the information requested is regarding the enrollee’s eligibility, coverage or health plan benefits or a claim for services provided on a date within the 2nd or 3rd month of the 3-month grace period, the carrier shall inform the provider that the enrollee is in the 3-month grace period.

1. Information provided. The carrier shall provide the information required under this section through the same medium through which the provider or representative of the provider sought the information. The information to be provided by the carrier must include:

A. The purpose of the notice;
B. The enrollee’s name and any unique identification numbers;
C. The name of the carrier and the carrier’s unique health plan identifier;
D. The specific date upon which the grace period for the enrollee began and the specific date it expires; and
E. A clear statement regarding whether the carrier intends to exercise its right under the federal Affordable Care Act to pend claims for the enrollee and subsequently not pay claims for care provided to the enrollee during the grace period if the enrollee fails to make premium payments or whether the carrier intends on recouping claims payments for services rendered during the grace period.

2. Failure to provide information. If a carrier does not provide information required by this section, the carrier must pay for all claims for services provided by a provider to the relevant enrollee during the time the enrollee was in the grace period.
3. Waiver. The notice required by this section may not be waived by contract, and contract provisions in conflict with this section are void and of no effect.
4. Effective date. This section takes effect January 1, 2016.

summary

This bill requires insurance carriers, beginning January 1, 2016, to give health care providers notice that an enrollee covered by an insurance product purchased through the American Health Benefit Exchange is in the 3-month grace period under 45 Code of Federal Regulations, Section 156.270(d)(2015).

Patterns of Support

Pattern of Cosponsorship by Region:

Pattern of Cosponsorship by Gender:

Pattern of Cosponsorship by Party:

Pattern of Cosponsorship by Campaign Finance Classification:

Note: Maine Clean Elections Act (MCEA) Qualified candidates only accept a small dollar value of initial contributions early in their campaigns, pledge not to accept further campaign contributions from private sources, and receive public funding for their campaigns. MCEA Non-Qualified candidates choose not to obtain public funding and instead are free to accept campaign contributions from individuals, party committees, political action committees and business sources.


This information about LD 704 was last updated on 2016-05-12.
The Open Maine Politics website is in a beta release and results should not be taken as definitive. Please visit the official website of the Maine State Legislature for entirely verifiable information.

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