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Me. Rev. Stat. tit. 24, § 2302-C

Penalty for noncompliance with utilization review programs

PL 1995, c. 332, §M2 (NEW).

A contract issued or renewed by a nonprofit service organization after April 8, 1994 may not contain a provision that permits, upon retroactive review and confirmation of medical necessity, the imposition of a penalty of more than $500 for failure to provide notification under a utilization review program. This section does not limit the right of nonprofit service organizations to deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary.

Official source: Maine Legislature. Reproduced from public-domain Maine statutes; confirm against the official source for the current text. Not legal advice.