Maine Code § 24-A-4250

Coverage for hospice care services
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(REALLOCATED FROM TITLE 24-A, SECTION 4249)
1. Definitions. As used in this section, unless the context otherwise indicates, the following terms
have the following meanings.
A. "Hospice care services" means services provided on a 24-hours-a-day, 7-days-a-week basis to
a person who is terminally ill and that person's family. "Hospice care services" includes, but is not
limited to, physician services; nursing care; respite care; medical and social work services;
counseling services; nutritional counseling; pain and symptom management; medical supplies and
durable medical equipment; occupational, physical or speech therapies; volunteer services; home
health care services; and bereavement services. [RR 2001, c. 1, §36 (RAL).]
B. "Person who is terminally ill" means a person that has a medical prognosis that the person's life
expectancy is 12 months or less if the illness runs its normal course. [RR 2001, c. 1, §36 (RAL).]
[RR 2001, c. 1, §36 (RAL).]
2. Coverage for hospice care services. All health maintenance organization individual and group
health contracts must provide coverage for hospice care services to a person who is terminally ill.
Hospice care services must be provided according to a written care delivery plan developed by a hospice
care provider and the recipient of hospice care services. Coverage for hospice care services must be
provided whether the services are provided in a home setting or an inpatient setting.
[RR 2001, c. 1, §36 (RAL).]
3. Application. The requirements of this section apply to all individual and group policies,
contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State.
For purposes of this section, all contracts are deemed to be renewed no later than the next yearly
anniversary of the contract date.
[PL 2003, c. 517, Pt. B, §29 (NEW).]

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