Maine Revised Statutes Title 24-A Sec. 4303-G – Provider maintenance of certification requirements
Current as of: 2023 | Check for updates
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(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29) (WHOLE SECTION TEXT REPEALED 4/1/29)
(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)
(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29)
(WHOLE SECTION TEXT REPEALED 4/1/29)
The following provisions govern maintenance of certification requirements. [PL 2023, c. 40, §1 (NEW).]
1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
A. “Hospital” means a hospital licensed and operating under Title 22, chapter 404 or 405 or the parent of such institution, or a hospital subsidiary or hospital affiliate in this State that provides medical services or medically related diagnostic and laboratory services or engages in ancillary activities supporting those services. [PL 2023, c. 40, §1 (NEW).]
B. “Maintenance of certification program” means satisfactory participation in a program beyond the continuing medical education requirements currently in place by the Board of Licensure in Medicine or Board of Osteopathic Licensure, or initial board certification by a national or regional medical specialty board. [PL 2023, c. 40, §1 (NEW).]
C. “Outpatient clinical practice” means any medical practice, home care or hospice organization or other nonhospital entity providing medical care through physicians. [PL 2023, c. 40, §1 (NEW).]
D. “Physician” means an individual licensed under Title 32, chapter 36 or 48. [PL 2023, c. 40, §1 (NEW).]
[PL 2023, c. 40, §1 (NEW).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4303-G
- Carrier: means :
A. See Maine Revised Statutes Title 24-A Sec. 4301-AHealth plan: means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan, other than a plan that provides only accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care or other limited benefit coverage not subject to the requirements of the federal Affordable Care Act. See Maine Revised Statutes Title 24-A Sec. 4301-A Provider: means a practitioner or facility licensed, accredited or certified to perform specified health care services consistent with state law. See Maine Revised Statutes Title 24-A Sec. 4301-A
2. Discrimination prohibited. A carrier offering a health plan in this State may not:
A. Deny reimbursement to a physician, hospital or outpatient clinical practice for services rendered because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW).]
B. Provide lower reimbursement for services rendered by a physician, hospital or outpatient clinical practice because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW).]
C. Prohibit a physician, hospital or outpatient clinical practice from participating in any of the carrier’s provider networks because a physician does not participate in a maintenance of certification program; or [PL 2023, c. 40, §1 (NEW).]
D. Determine credentialing of a physician, hospital or outpatient clinical practice based on the status of a physician’s, hospital’s or outpatient clinical practice’s participation in a maintenance of certification program. [PL 2023, c. 40, §1 (NEW).]
[PL 2023, c. 40, §1 (NEW).]
3. Repeal. This section is repealed April 1, 2029.
[PL 2023, c. 40, §1 (NEW).]
SECTION HISTORY
PL 2023, c. 40, §1 (NEW).