02-031-330 Me. Code R. § 9
Current through 2025-03, January 15, 2025
When a preferred provider arrangement is used, benefits for services of a non-preferred provider may not reduce benefits below the minimums set forth in this rule. If a point-of-service option is provided as part of an HMO plan, benefit levels may be lower than the mandated levels only for the self-referred services. No penalties under a utilization review program may reduce benefits below the minimums set forth in this rule.
02-031 C.M.R. ch. 330, § 9