Bill > LD910

This bill requires health insurance carriers to provide quarterly reports to the Superintendent of Insurance starting in 2026, detailing the number of claims and prior authorization requests that were denied during each quarter. The reports must include the five most common reasons for claim denials and prior authorization denials, listed in order of frequency. By January 31st each year, the Superintendent must submit an annual report to the legislative committee responsible for health coverage and insurance, which will include not only the data from insurance carriers but also claim and prior authorization denial information from the U.S. Department of Health and Human Services related to the Affordable Care Act (ACA). The legislative committee is then authorized to propose legislation based on the findings in the annual report. This bill aims to increase transparency in health insurance claim and prior authorization processes by systematically collecting and reporting denial data, which could help identify potential issues in healthcare access and insurance practices.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=910&snum=132