Me. Stat. tit. 24-A § 4329

Current through 131st (2023-2024) Legislature Chapter 684
Section 4329 - Independent health care provider assistance
1. Independent health care provider defined. For the purposes of this section, "independent health care provider" means an independent health care practitioner or group of independent health care practitioners with 6 or fewer health care practitioners, but does not include a health care practitioner employed by a hospital or health system or a group of health care practitioners that is owned or operated, in whole or in part, by a hospital or health system.
2.Liaison program. The bureau shall establish a liaison program, referred to in this section as "the program," to provide assistance to independent health care providers as set forth in this section.
3. Duties. The duties of the program include:
A. Providing information to independent health care providers on how to contact the program for assistance through the bureau's publicly accessible website and through a toll-free number;
B. Providing information to independent health care providers on the bureau's publicly accessible website regarding the State's health insurance laws and rules and the rights and responsibilities of carriers and health care providers;
C. Assisting independent health care providers with inquiries related to the State's health insurance laws and rules; and
D. Receiving information from independent health care providers regarding regulatory or compliance issues that may have a market-wide impact.
4.Provider complaint process. The bureau shall establish a process to receive and investigate complaints from independent health care providers regarding an alleged violation of any provision of this Title or any rule adopted pursuant to this Title. The bureau may also receive and investigate complaints from providers other than independent health care providers.
5. Confidentiality. With respect to the program or complaints, records, correspondence and reports of investigation in connection with actual or claimed violations of this Title or a rule adopted pursuant to this Title are confidential to the same extent as records, correspondence and reports of investigation of consumer complaints under section 216.
6. Procedures for data collection. The bureau may establish procedures for collecting, tracking and quantifying requests for assistance and complaints.
7.Aggregate information. The bureau shall compile and publish aggregate information regarding complaints received under subsection 4 on its publicly accessible website.
8. Staffing resources. The bureau may consider staffing resources and any limitations on those resources when establishing guidelines regarding the assistance provided through the program and complaint process.
9. Rules. The bureau may adopt rules to implement this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.
10.No legal representation. This section does not authorize the bureau to act as a legal representative of a provider or to provide assistance with contract negotiations or interpretations of the terms of contracts between providers and carriers in any manner through the program or complaint process.

24-A M.R.S. § 4329

Added by 2024, c. 590,§ 1, eff. 8/9/2024.