§ 2670 Short title
§ 2671 Definitions
§ 2672 Selective contracting authorized
§ 2673-A Preferred provider arrangements
§ 2674-A Requirements for administrators and carriers
§ 2676 Risk transfer
§ 2677-A Payment for nonpreferred providers
§ 2678 Annual experience report
§ 2680 Standardized claim form

Terms Used In Maine Revised Statutes > Title 24-A > Chapter 32 - Preferred Provider Arrangement Act

(a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Authority: means the Maine Health and Higher Educational Facilities Authority created and established as a public body corporate and politic of the State of Maine by section 2054 or any board, body, commission, department or officer succeeding to the principal functions thereof or to whom the powers conferred upon the authority by this chapter shall be given by law. See Maine Revised Statutes Title 22 Sec. 2053
  • Bank: includes savings banks, savings and loan associations, credit unions and trust companies. See Maine Revised Statutes Title 11 Sec. 9-1102
  • 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
  • Carrier: means an insurance company licensed in accordance with this Title, a fraternal benefit society authorized pursuant to chapter 55 or a nonprofit hospital or medical service organization licensed pursuant to Title 24. See Maine Revised Statutes Title 24-A Sec. 2671
  • Certificate of title: includes another record maintained as an alternative to a certificate of title by the governmental unit that issues certificate of title if a statute permits the security interest in question to be indicated on the record as a condition or result of the security interest's obtaining priority over the rights of a lien creditor with respect to the collateral. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Chattel paper: means a record or records that evidence both a monetary obligation and a security interest in specific goods, a security interest in specific goods and license of software used in the goods, a lease of specific goods or a lease of specific goods and license of software used in the goods. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Collateral: includes :
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Commissioner: means the Commissioner of Health and Human Services. See Maine Revised Statutes Title 22 Sec. 1-A
  • Commodity account: means an account maintained by a commodity intermediary in which a commodity contract is carried for a commodity customer. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Commodity contract: means a commodity futures contract, an option on a commodity futures contract, a commodity option or another contract if the contract or option is:
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Commodity customer: means a person for which a commodity intermediary carries a commodity contract on its books. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Commodity intermediary: means a person that:
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Contract: A legal written agreement that becomes binding when signed.
  • Debtor: means :
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Decedent: A deceased person.
  • Department: means the Department of Health and Human Services. See Maine Revised Statutes Title 22 Sec. 1-A
  • Deposit account: means a demand, time, savings, passbook or similar account maintained with a bank. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Devise: To gift property by will.
  • Enrollee: means an individual entitled to reimbursement for expenses of health care services under a health plan. See Maine Revised Statutes Title 24-A Sec. 2671
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Ex officio: Literally, by virtue of one's office.
  • Farm products: means goods, other than standing timber, with respect to which the debtor is engaged in a farming operation and that are:
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Financing statement: means a record or records composed of an initial financing statement and any filed record relating to the initial financing statement. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • Goods: includes :
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Health care facility: means a nursing home that is, or will be upon completion, licensed under chapter 405; a residential care facility that is, or will be upon completion, licensed under chapter 1663; a continuing care retirement community that is, or will be upon completion, licensed under Title 24-A, chapter 73; an assisted living facility that is, or will be upon completion, licensed under chapter 1664; a hospital; a community mental health facility; a scene response air ambulance licensed under Title 32, chapter 2-B and the rules adopted thereunder; a facility of a hospice program that is, or will be upon completion, licensed under chapter 1681; a nonprofit statewide health information network incorporated in the State for the purpose of exchanging health care information among licensed health care providers in the State; or a community health center. See Maine Revised Statutes Title 22 Sec. 2053
  • Health care services: means health care services or products rendered or sold by a provider within the scope of the provider's legal authorization. See Maine Revised Statutes Title 24-A Sec. 2671
  • Health 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. See Maine Revised Statutes Title 24-A Sec. 2671
  • Health-care-insurance receivable: means an interest in or claim under a policy of insurance that is a right to payment of a monetary obligation for health-care goods or services provided or to be provided. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Institution for higher education: means :
  • A. See Maine Revised Statutes Title 22 Sec. 2053
  • Institution providing an educational program: means a nonprofit or charitable institution, public or private, that is exempt from federal taxation pursuant to the United States Internal Revenue Code of 1986, as amended, Section 501 and that provides a program of education for the purpose of enhancing the knowledge or abilities of its members or the general public. See Maine Revised Statutes Title 22 Sec. 2053
  • Investment property: means a security, whether certificated or uncertificated, security entitlement, securities account, commodity contract or commodity account. See Maine Revised Statutes Title 11 Sec. 9-1102
  • 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
  • Letter-of-credit right: means a right to payment or performance under a letter of credit, whether or not the beneficiary has demanded or is at the time entitled to demand payment or performance. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Lien: A claim against real or personal property in satisfaction of a debt.
  • Majority: when used in reference to age shall mean the age of 18 and over. See Maine Revised Statutes Title 1 Sec. 72
  • Mortgage: The written agreement pledging property to a creditor as collateral for a loan.
  • Oath: includes an affirmation, when affirmation is allowed. See Maine Revised Statutes Title 1 Sec. 72
  • Oath: A promise to tell the truth.
  • 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.
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Participating health care facility: means a health care or licensed assisted living facility that, pursuant to this chapter, undertakes the financing and construction or acquisition of a project or undertakes the refunding or refinancing of existing indebtedness as provided in and permitted by this chapter. See Maine Revised Statutes Title 22 Sec. 2053
  • Participating institution for higher education: means an institution for higher education which, pursuant to this chapter, shall undertake the financing and construction or acquisition of a project or shall undertake the refunding or refinancing of obligations or of a mortgage or of advances as provided in and permitted by this chapter. See Maine Revised Statutes Title 22 Sec. 2053
  • Participating institution providing an educational program: means an institution providing an educational program that, pursuant to this chapter, undertakes the financing and construction or acquisition of a project or undertakes the refunding or refinancing of obligations or of a mortgage or of advances as provided in and permitted by this chapter. See Maine Revised Statutes Title 22 Sec. 2053
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Payment intangible: means a general intangible under which the account debtor's principal obligation is a monetary obligation. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Preferred provider: means a provider who enters into a preferred provider arrangement with an administrator or carrier. See Maine Revised Statutes Title 24-A Sec. 2671
  • Preferred provider arrangement: means a contract, agreement or arrangement between a carrier or administrator and a provider in which the provider agrees to provide services to a health plan enrollee whose plan benefits include incentives for the enrollee to use the services of that provider. See Maine Revised Statutes Title 24-A Sec. 2671
  • Proceeds: means the following property:
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • Project: includes all real and personal property, lands, improvements, driveways, roads, approaches, pedestrian access roads, rights-of-way, utilities, easements and other interests in land, machinery and equipment, and all appurtenances and facilities either on, above or under the ground that are used or usable in connection with any of the structures mentioned in this paragraph, and also includes landscaping, site preparation, furniture, machinery, equipment and other similar items necessary or convenient for the operation of a particular facility or structure in the manner for which its use is intended, but does not include such items as books, fuel, supplies or other items that are customarily considered as a current operating charge; and [PL 2007, c. See Maine Revised Statutes Title 22 Sec. 2053
  • Promissory note: means an instrument that evidences a promise to pay a monetary obligation, does not evidence an order to pay and does not contain an acknowledgment by a bank that the bank has received for deposit a sum of money or funds. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Provider: means an individual or entity duly licensed or otherwise legally authorized to provide health care services, including, but not limited to, the treatment of physical health and mental health and provision for medical supplies and pharmaceutical supplies. See Maine Revised Statutes Title 24-A Sec. 2671
  • Quorum: The number of legislators that must be present to do business.
  • Real property: Land, and all immovable fixtures erected on, growing on, or affixed to the land.
  • Refinancing of existing indebtedness: means liquidation, with the proceeds of bonds or notes issued by the authority, of an indebtedness of a health care facility, an institution for higher education or a participating institution providing an educational program incurred to finance or aid in financing a lawful purpose of that health care facility, institution for higher education or participating institution providing an educational program not financed pursuant to this chapter that would constitute a project had it been undertaken and financed by the authority, or consolidation of such indebtedness with indebtedness of the authority incurred for a project related to the purpose for which the indebtedness of the health care facility, institution for higher education or participating institution providing an educational program was incurred. See Maine Revised Statutes Title 22 Sec. 2053
  • Registered organization: means an organization formed or organized solely under the law of a single state or of the United States by the filing of a public organic record with, the issuance of a public organic record by or the enactment of legislation by the state or the United States. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Secured party: means :
  • (a). See Maine Revised Statutes Title 11 Sec. 9-1102
  • State: means a state of the United States, the District of Columbia, Puerto Rico, the United States Virgin Islands or any territory or insular possession subject to the jurisdiction of the United States. See Maine Revised Statutes Title 11 Sec. 9-1102
  • Statute: A law passed by a legislature.
  • Superintendent: means the Superintendent of Insurance. See Maine Revised Statutes Title 24-A Sec. 2671
  • Trustee: A person or institution holding and administering property in trust.
  • Uniform Commercial Code: A set of statutes enacted by the various states to provide consistency among the states' commercial laws. It includes negotiable instruments, sales, stock transfers, trust and warehouse receipts, and bills of lading. Source: OCC