§ 3811 Definitions
§ 3812 Notice to recipient
§ 3813 Notice to repay
§ 3814 Service
§ 3815 Exempt property
§ 3816 Income withholding
§ 3817 Assignment of earnings
§ 3818 Payor compensation
§ 3819 Payor protected
§ 3820 Failure to honor
§ 3821 Employee protected
§ 3822 Liens
§ 3823 Foreclosure on liens
§ 3824 Credit reporting
§ 3825 Exceptions to collections from minors

Terms Used In Maine Revised Statutes > Title 22 > Subtitle 3 > Part 3 > Chapter 1055-A - Collection of Overpayments

  • Adult: means a person who has attained the age of 18 years. See Maine Revised Statutes Title 1 Sec. 72
  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Annuity: A periodic (usually annual) payment of a fixed sum of money for either the life of the recipient or for a fixed number of years. A series of payments under a contract from an insurance company, a trust company, or an individual. Annuity payments are made at regular intervals over a period of more than one full year.
  • Answer: The formal written statement by a defendant responding to a civil complaint and setting forth the grounds for defense.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Assistance unit: means the individuals whose need the department considers when determining whether an applicant or recipient is eligible for program benefits. See Maine Revised Statutes Title 22 Sec. 3811
  • Attorney-in-fact: A person who, acting as an agent, is given written authorization by another person to transact business for him (her) out of court.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Basic health care services: means health care services that an enrolled population might reasonably require in order to be maintained in good health and includes, at a minimum, emergency care, inpatient hospital care, inpatient physician services, outpatient physician services, ancillary services such as x-ray services and laboratory services and all benefits mandated by statute and mandated by rule applicable to health maintenance organizations. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Benefit corporation: means a corporation:
A. See Maine Revised Statutes Title 13-C Sec. 1802
  • Benefit director: means the director designated as the benefit director of a benefit corporation under section 1822. See Maine Revised Statutes Title 13-C Sec. 1802
  • Benefit enforcement proceeding: means a claim or action or proceeding for:
    • A. See Maine Revised Statutes Title 13-C Sec. 1802
  • Benefit officer: means the individual designated as the benefit officer of a benefit corporation under section 1824. See Maine Revised Statutes Title 13-C Sec. 1802
  • Capitated basis: means fixed per-member, per-month payments or percentage-of-premium payments pursuant to which the provider assumes full risk for the cost of contracted services without regard to the type, value or frequency of services provided. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Carrier: means a health maintenance organization, an insurer, a nonprofit hospital, a medical service corporation or any other entity responsible for the payment of benefits or provision of services under a group contract. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Commissioner: means the Commissioner of Health and Human Services. See Maine Revised Statutes Title 22 Sec. 1-A
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Copayment: means an amount an enrollee must pay in order to receive a specific service that is not fully prepaid. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Deductible: means the amount an enrollee is responsible to pay out of pocket before a health maintenance organization begins to pay the costs associated with treatment. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Dependent: A person dependent for support upon another.
  • Enrollee: means an individual who is enrolled in a health maintenance organization. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Fiduciary: A trustee, executor, or administrator.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Foreclosure: A legal process in which property that is collateral or security for a loan may be sold to help repay the loan when the loan is in default. Source: OCC
  • General public benefit: means a material positive impact on society and the environment, taken as a whole, assessed against a 3rd-party standard, from the business and operations of a benefit corporation. See Maine Revised Statutes Title 13-C Sec. 1802
  • Group contract holder: means an entity or person that has purchased coverage from a health maintenance organization that provides, at a minimum, basic health care services to enrollees. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • 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 insurance: means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38. See Maine Revised Statutes Title 24-A Sec. 704
  • 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-A
  • in writing: include printing and other modes of making legible words. See Maine Revised Statutes Title 1 Sec. 72
  • In-plan covered services: includes emergency services. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Independent: means having no material relationship with a benefit corporation or a subsidiary of the benefit corporation, except that serving as benefit director or benefit officer does not make an individual not independent. See Maine Revised Statutes Title 13-C Sec. 1802
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • lands: includes lands and all tenements and hereditaments connected therewith, and all rights thereto and interests therein. See Maine Revised Statutes Title 1 Sec. 72
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Minimum status vote: means :
    • A. See Maine Revised Statutes Title 13-C Sec. 1802
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Municipality: includes cities, towns and plantations, except that "municipality" does not include plantations in Title 10, chapter 110, subchapter IV; or Title 30?A, Part 2. See Maine Revised Statutes Title 1 Sec. 72
  • National Association of Insurance Commissioners: means the National Association of Insurance Commissioners or its successor organization of insurance regulators. See Maine Revised Statutes Title 24-A Sec. 15
  • NCQA accreditation survey report: means the unpublished, detailed survey report to a health maintenance organization by the National Committee for Quality Assurance upon completion of NCQA's accreditation survey of the health maintenance organization. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Nonprofit hospital or medical service organization: means any organization defined in and authorized to act under Title 24, chapter 19. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Obligor: means an individual who receives an overpayment or an adult individual who is a member of an assistance unit that receives an overpayment. See Maine Revised Statutes Title 22 Sec. 3811
  • Out-of-plan covered services: means nonemergency, covered health care services obtained without a referral from providers who are not otherwise employed by, under contract with or otherwise affiliated with the health maintenance organization or from affiliated specialists. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Overpayment: means program benefits that exceed the amount of program benefits for which an individual or assistance unit is eligible when the department or a court has determined that the benefits were provided as a result of an intentional program violation, an unintentional error by the individual or household or an error by the department. See Maine Revised Statutes Title 22 Sec. 3811
  • Participating provider: means a provider as defined in subsection 18 that, under an express or implied contract with a health maintenance organization, has agreed to provide health care services to enrollees with an expectation of receiving payment, other than copayment, directly or indirectly from the health maintenance organization. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Person: means an individual, firm, partnership, corporation, association, syndicate, organization, society, business trust, attorney-in-fact or any legal entity. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Personal property: All property that is not real property.
  • Plaintiff: The person who files the complaint in a civil lawsuit.
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Point-of-service option: means a health maintenance organization product that allows an enrollee to select either the comprehensive health care benefits of the health maintenance organization or care from a provider of the enrollee's choice outside the health maintenance organization network with traditional indemnity benefits. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Point-of-service product: means a product that includes both in-plan covered services and out-of-plan covered services. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • premiums: as used in this chapter means premiums, rates or other required contributions by whatever name known. See Maine Revised Statutes Title 24-A Sec. 4120
  • Program benefits: means money payments or food coupons issued by the department pursuant to an application for benefits made by an individual to Aid to Families with Dependent Children established in former chapter 1053, the Supplemental Nutrition Assistance Program established in chapter 851 or the Temporary Assistance for Needy Families program established in chapter 1053?B, or money payments or vouchers issued by a municipal general assistance program established pursuant to chapter 1161, or payments for medical services issued by the department pursuant to the MaineCare program established pursuant to chapter 855. See Maine Revised Statutes Title 22 Sec. 3811
  • Provider: means a physician, hospital or person that is licensed or otherwise authorized in this State to furnish health care services. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Specific public benefit: means any particular benefit to society or the environment, including without limitation:
    • A. See Maine Revised Statutes Title 13-C Sec. 1802
  • Subsidiary: means , in relation to a person, an entity in which the person owns beneficially or of record 50% or more of the outstanding equity interests, calculated as if all outstanding rights to acquire equity interests in the entity had been exercised. See Maine Revised Statutes Title 13-C Sec. 1802
  • Superintendent: means the Superintendent of Insurance. See Maine Revised Statutes Title 24-A Sec. 4202-A
  • Town: includes cities and plantations, unless otherwise expressed or implied. See Maine Revised Statutes Title 1 Sec. 72
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • Trustee: A person or institution holding and administering property in trust.
  • Uncovered expenditures: means costs to a health maintenance organization for health care services that are the obligation of the health maintenance organization for which an enrollee may also be liable. See Maine Revised Statutes Title 24-A Sec. 4202-A