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Maine.gov > PFR Home > Insurance Regulation > Laws, Rules & Decisions > Notice of Rulemaking

NOTICE OF RULEMAKING

Notice is hereby given that the Superintendent of Insurance will hold a public hearing on December 20, 2011 at 9:00 a.m. in the Central Conference Room of the Department of Professional and Financial Regulation building, 76 Northern Avenue, Gardiner, Maine to receive comments concerning proposed amendments to Rule Chapter 850 – Health Plan Accountability.

The purposes of the amendments are to reflect changes in underlying Maine law relating to health plan network adequacy standards enacted pursuant to 2011 PL c. 90 and to assimilate federal standards relating to grievance procedures, internal appeals and external appeals. A copy of the proposal is attached.

This rule is proposed in accordance with 24-A M.R.S.A. §§2772, 2774, 4218, 4218-A, 4222-A, 4303, 4309, and 4309-A.

Primary sources of information relied upon by the Bureau of Insurance in developing the proposed rule include the network adequacy standards 2012 Standards and Guidelines for the Accreditation of Health Plans of the National Committee for Quality Assurance (NCQA), the U.S. Public Health Service Act Section 2719, interim final Internal Claims and Appeals and External Review Processes regulations (45 CFR 147.136), 29 CFR 2560.503-1and professional judgment.

All interested persons are invited to provide oral comments at the hearing or to submit written comments. Written comments must be received no later than January 6, 2012 at 5:00 p.m. and should be addressed to: Sarah Hewett, Maine Bureau of Insurance, 34 State House Station, Augusta, Maine 04333.

The Department of Professional and Financial Regulation does not discriminate on the basis of disability in the admission to, access to, or operation of its programs, services or activities. Individuals in need of auxiliary aid for effective communication in the hearing are invited to make their needs and preference known to Sarah Hewett at the Bureau of Insurance, telephone (207) 624-8412, sufficiently in advance of the hearing so that appropriate arrangements can be made.

 

DATED: November 21, 2011 ________________________
Eric A. Cioppa
Superintendent of Insurance

 

Last Updated: November 29, 2011