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Maine.gov > PFR Home > Insurance Regulation > Producer Services > Medical Utilization Review

Medical Utilization Review

To: State of Maine Medical Utilization Review Entity Initial license applicants.

Enclosed please find the application kit to be used when applying for a license to perform medical utilization review services. The kit includes the following:

1. The application (two-sided) - Word or Adobe PDF

2. A copy of Title 24-A M.R.S.A. Chapter 34, Licensure of Medical Utilization Review Entities.

3. A copy of Maine Bureau of Insurance Bulletin # 265, Utilization Review Determinations.

4. A copy of Title 24-A M.R.S.A. Chapter 56-A, Health Plan Improvement Act.

5. A copy of Maine Bureau of Insurance Rule Chapter 850, Health Plan Accountability.

6. A copy of Title 24 M.R.S.A. §2302-B and copies of Title 24-A M.R.S.A. §§2749(A) and 2847(A), entitled, Notice of Emergency Treatment.

Prior to submitting an application to obtain a medical utilization review license, please make certain that the medical utilization review programs the applicant seeks to perform are in full compliance with the statutes, regulation, and bulletin referenced above.

Please direct your completed application and attending exhibits to:

Patty Woods
Claims Examiner
Consumer Health Care Division
Maine Bureau of Insurance
34 State House Station
Augusta ME 04333-0034
Tel. (207) 624-8459

Last Updated: December 8, 2011