Maine 2023-2024 Regular Session

Maine House Bill LD1766

Introduced
4/25/23  
Refer
4/25/23  
Refer
4/25/23  

Caption

An Act to Require Insurance Carriers to Compensate Providers for Costs of Providing Medical Records for Utilization Review

Impact

The implementation of LD1766 is expected to positively impact state laws concerning healthcare reimbursement practices. It addresses a critical aspect of the healthcare delivery system, particularly how insurance companies handle requests for medical information. By legislating that providers must be compensated for reasonable expenses, the bill underscores the importance of shared responsibility between insurers and providers, potentially leading to a more equitable healthcare landscape. This requirement may also incentivize providers to respond more promptly to records requests, thereby benefiting patient care continuity.

Summary

LD1766 aims to mandate that insurance carriers compensate healthcare providers for the costs incurred in providing medical records needed for utilization reviews. This bill recognizes the need for fair compensation to providers who often bear the burden of administrative costs associated with gathering and transmitting these medical documents. By ensuring that providers receive reimbursement for reasonable expenses, the legislation seeks to encourage compliance and facilitate smoother processing of utilization requests, ultimately aiming to improve efficiency within the healthcare system.

Sentiment

The sentiment around LD1766 appears to be largely positive among healthcare providers who advocate for more equitable compensation structures in their dealings with insurance companies. Supporters argue that this bill is a step towards rectifying longstanding issues related to administrative burdens and lack of payment for necessary services. However, there may be concerns from insurance carriers regarding the implications of increased expenses and how this could impact their operational costs. Thus, while providers see it as a favorable move, insurers may view it with caution.

Contention

Key points of contention surrounding LD1766 could arise from differing opinions on what constitutes 'reasonable expenses.' While providers may argue for broader definitions to encompass a wide range of costs, insurers might seek to limit these expenses to only the most essential costs associated with record transmission. Additionally, discussions may also revolve around the potential administrative burden on insurance companies to manage and implement the reimbursement processes set forth by the bill. This dialogue highlights ongoing debates about cost-sharing and responsibilities in the healthcare system.

Companion Bills

No companion bills found.

Previously Filed As

ME HB932

Health Insurance - Utilization Review - Revisions

ME SB791

Health Insurance - Utilization Review - Revisions

ME HB305

Health Insurance - Utilization Review - Revisions

ME SB308

Health Insurance – Utilization Review – Revisions

ME SB636

Workers’ compensation: utilization review.

ME SB924

Workers’ compensation: utilization review.

ME SB01158

An Act Concerning Utilization Review, Grievances And External Appeals Processes Of Health Carriers.

ME SB292

Provides relative to utilization reviews for health insurance policies. (8/1/20)

ME SB00375

An Act Authorizing Multistate Health Care Centers In Connecticut And Eliminating A Health Carrier Utilization Review Report Filing Requirement.

ME SB93

Health Insurance – Utilization Review – Private Review Agents

Similar Bills

No similar bills found.