Maine Revised Statutes Title 24-A Sec. 4215 – Examinations
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1. The superintendent may make an examination of the affairs of any health maintenance organization as often as the superintendent considers it necessary for the protection of the interests of the people of this State, but not less frequently than once every 3 years. The superintendent may defer making an examination for no more than 2 additional years. In lieu of the superintendent’s making an examination of a foreign or alien health maintenance organization, the superintendent may accept a full report of the most recent examination certified by the chief regulatory official of another state with responsibility for the financial oversight of health maintenance organizations.
[PL 2021, c. 16, §13 (AMD).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4215
- Health care services: means any services included in the furnishing of medical care, dental care or hospitalization to an individual, or any services incident to the furnishing of that care or hospitalization, as well as the furnishing of any other services to an individual to prevent, alleviate, cure or heal human illness or injury. See Maine Revised Statutes Title 24-A Sec. 4202-A
- Health maintenance organization: means a public or private organization that is organized under the laws of the Federal Government, this State, another state or the District of Columbia or a component of such an organization, and that:
A. See Maine Revised Statutes Title 24-A Sec. 4202-AOversight: Committee review of the activities of a Federal agency or program. Superintendent: means the Superintendent of Insurance. See Maine Revised Statutes Title 24-A Sec. 4202-A
2. The Commissioner of Health and Human Services may make an examination concerning the quality of health care services of any health maintenance organization as often as the commissioner considers it necessary for the protection of the interests of the people of this State, but not less frequently than once every 3 years.
[RR 2021, c. 1, Pt. B, §346 (COR).]
3. Every health maintenance organization shall submit its books and records relating to health care services to such examinations and in every way facilitate them. For the purpose of examinations, the superintendent and the Commissioner of Health and Human Services may administer oaths to and examine the officers and agents of the health maintenance organization.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
4. The expenses of examinations under this section shall be assessed against the organization being examined and remitted to the superintendent or the Commissioner of Health and Human Services for whom the examination is being conducted.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
5. In lieu of such examination, the superintendent or Commissioner of Health and Human Services may accept the report of an examination made by persons holding comparable office of another state.
[PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
SECTION HISTORY
PL 1975, c. 293, §4 (AMD). PL 1975, c. 503 (NEW). PL 2003, c. 689, §B7 (REV). PL 2021, c. 16, §13 (AMD). RR 2021, c. 1, Pt. B, §346 (COR).