Maine Code § 24-A-2749-B

Penalty for noncompliance with utilization review programs
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A health insurance policy issued or renewed in this State after April 8, 1994 may not contain a
provision that permits, upon retroactive review and confirmation of medical necessity, the imposition
of a penalty of more than $500 for failure to provide notification under a utilization review program.
This section does not limit the right of insurers to deny a claim when appropriate prospective or
retroactive review concludes that services or treatment rendered were not medically necessary. [PL
1995, c. 332, Pt. M, §4 (AMD).]

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