An Act To Protect Consumers from Surprise Emergency Medical Bills
Maine Legislature, Session 129, LD 2105
Committee Amendment CA_A_H773 (House)
Amends: 22 MRSA §1718-D, 24-A MRSA §4303-C, 24-A MRSA §4303-E, 24-A MRSA §4320-C

COMMITTEE AMENDMENT •'IJ. " to H.P. 1501, L.D. 2105, Bill, "An Act To 
Protect Consumers from Surprise Emergency Medical Bills" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec, 1. 22 MRSA §1718-D, as enacted by PL 2017, c. 218, §1 and affected by §3, 
is amended to read: 
§1718-D. Prohibition on balance billing for surprise bills and bills for out-of-
network emergency services; disputes of bills for uninsured patients and 
persons covered under self-insured health benefit plans 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Enrollee" has the same meaning as in Title 24-A, section 4301-A, subsection 5. 
B. "Health plan" has the same meaning as in Title 24-A, section 4301-A, subsection 
7. 
B-1. "Knowingly elected to obtain the services from an out-of-network provider" 
means that an enrollee chose the services of a specific provider, with full knowledge 
that the provider is an out-of-network provider with respect to the enrollee's health 
plan, under c:ircumstances that indicate that the enrollee had and was informed of the 
opportunity to receive services from a network provider but instead selected the out-
of-network provider. The disclosure by a provider of network status does not render 
an enrollee's decision to proceed with treatment from that provider a choice made 
knowingly pursuant to this paragraph. 
C. "Provider" has the same meaning as in Title 24-A, section 4301-A, subsection 16. 
D. "Surprise bill" has the same meaning as in Title 24-A, section 4303-C, subsection 
1. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1501, L.D. 2105 
E. "Visit" means any interaction between an enrollee and one or more providers for 
the purpose of assessing the health status of an enrollee or providing one or more 
health care services between the time an enrollee enters a facility and the time an 
enrollee is discharged. 
2. Prohibition on balance billing. An out-of-network provider reimbursed for a 
surprise bill or a bill for covered emergency services under Title 24-A, section 4303-C, 
subsection 2, paragraph B or. if there is a dispute. under Title 24-A. section 4303-E may 
not bill an enrollee for health care services beyond the applicable coinsurance, 
copayment, deductible or other out-of-pocket cost expense that would be imposed for the 
health care services if the services were rendered by a network provider under the 
enrollee's health plan. For an enrollee subject to coinsurance, the out-of-network provider 
shall calculate the coinsurance amount based on the median network rate for that health 
care service under the enrollee's health plan. An out-of-network provider is also subiect 
to the following with respect to any overpayment made by an enrollee. 
A. If an out-of-network provider provides health care services covered under an 
enrollee's health plan and the out-of-network provider receives payment from the 
enrollee for health care services for which the enrollee is not responsible pursuant to 
this subsection. the out-of-network provider shall reimburse the enrollee within 30 
calendar days after the earlier of the date that the provider received notice of the 
overpayment and the date the provider became aware of the overpayment. 
B. An out-of-network provider that fails to reimburse an enrollee for an overpayment 
as required by paragraph A shall pay interest on the overpayment at the rate of 10% 
per annum beginning on the earlier of the date the provider received notice of the 
overpayment and the date the provider became aware of the overpayment. An 
enrollee is not required to request the accrued interest from the out-of-network 
provider in order to receive interest with the reimbursement amount. 
3, Uninsured patients; disputes of bHis. An uninsured patient who has received a 
bill for emergency services from a provider for one or more emergency health care 
services rendered during a single visit totaling $750 or more may dispute the bill and 
request resolution of the dispute using the process under Title 24-A. section 4303-E. The 
independent dispute resolution entity contracted to resolve the dispute over the surprise 
bill shall select either the out-of-network . provider's fee or the uninsured patient's 
proposed payment amount in accordance with Title 24-A. section 4303-E. An uninsured 
patient may not be charged by a provider more than the amounts generally billed to a 
patient who has insurance covering emergency services as determined using the method 
described in 26 Code of Federal Regulations. Section 1.S0l(r)-5, paragraph (b)(3) or 
(b)(4). A provider shall hold the uninsured patient harmless for the duration of the 
independent dispute resolution process and may not seek payment until the independent 
dispute resolution process is completed. Notwithstanding Title 24-A. section 4303-E, 
subsection L paragraph F, payment for the independent dispute resolution process is the 
responsibility of the provider. In the event a claim includes more than one emergency 
health care service rendered during a single visit. the independent dispute resolution 
entity may allocate the prorated independent dispute resolution costs at its discretion 
among providers. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "4 "to H.P. 1501, L.D. 2105 
4. Person covered under self-insured health benefit plan; disputes of surprise 
bills or bills for covered emergency services rendered by an out-of-network 
provider. A person covered under a self-insured health benefit plan that is not subject to 
the provisions of Title 24-A. section 4303-E pursuant to Title 24-A, section 4303-E, 
subsection 2 and who has received a sµrprise bill for emergency services or a bill for 
covered emergency services rendered by an out-of-network provider may dispute the bill 
and request resolution of the dispute using the process under Title 24-A, section 4303-E, 
subsection 1. The independent dispute resolution entity contracted to resolve the dispute 
over the bill shall select either the out-of-network provider's fee or the covered person's 
proposed payment amount in accordance with Title 24-A, section 4303-E, subsection 1. 
This subsection does not apply to a person covered under a self-insured he~lth benefit 
plan who know'ingly elected to obtain the services from an out-of-network provider. 
Sec. 2. 24-A MRSA §4303-C, as enacted by PL 2017, c. 218, §2 and affected by 
§3, is amended to read: 
§4303-C. Protection from surprise bills and bills for out-of-network emergency 
services 
1. Surprise bill defined. As used in this section, unless the context otherwise 
indicates, "surprise bill" means a bill for health care services, other than including. but not 
limited to, emergency services, received by an enrollee for covered services rendered by 
an out-of-network provider, when such services were rendered by that out-of-network 
provider at a network provider, during a service or procedure performed by a network 
provider or during a service or procedure previously approved or authorized by the carrier 
and the enrollee did not knowingly elect to obtain such services from that out-of-network 
provider. 
11Surprise bill" does not include a bill for health care services received by an 
enrollee when a network provider was available to render the services and the enrollee 
knowingly elected to obtain the services from another provider who was an out-of-
network provider. 
1-A. 
"Knowingly elected to obtain such services from that out-of-network 
provider" defmed. As used in this section. unless the context otherwise indicates, 
"knowingly elected to obtain such services from that out-of-network provider" means that 
an enrollee chose the services . of a specific provider. with full knowledge that the 
provider is an out-of-network provider with respect to the enrollee's health plan. under 
circumstances that indicate that the enrollee had and was informed of the opportunity to 
receive services from a network provider but instead selected the out-of-network 
provider. The disclosure by a provider of network status does not render an enrollee's 
decision to proceed with treatment from that provider a choice made knowingly pursuant 
to this subsection, 
2. Requirements. With respect to a surprise bill or a bill for covered emergency 
services rendered by an out-of-network provider: 
A. 
A carrier shall require an enrollee to pay only the applicable coinsurance, 
copayment, deductible or other out-of-pocket expense that would be imposed for 
health care services if the services were rendered by a network provider. For an 
enrollee subject to coinsurance. the carrier shall calculate the coinsurance amount 
based on the median network rate for that health care service; 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT ,fi,, to H.P. 1501, L.D. 2105 
B. A Except as provided for ambulance services in paragraph D. unless the carrier 
and out-of-network provider agree otherwise. a carrier shall reimburse the out-of-
network provider or enrollee, as applicable, for health care services rendered at the 
average network rate under the enrollee's health eare plan as pay-m.ent in full, unless 
the carrier aad out of ootwork provider agree otherwise; and greater of: 
(l} The carrier's median network rate paid for that health care service by a 
similar provider in the enrollee's geographic area: and 
(2) The median network rate paid by all carriers for that health care service by a 
similar provider in the enrollee's geographic area as determined by the all-payer 
claims database maintained by the Maine Health Data Organization or, if Maine 
Health Data Organization claims data is insufficient or otherwise inapplicable. 
another independent medical claims database; 
C. 
Notwithstanding paragraph B, if a carrier has an inadequate network, as 
determined by the superintendent, the carrier shall ensure that the enrollee obtains the 
covered service at no greater cost to the enrollee than if the service were obtained 
from a network provider or shall make other arrangements acceptable to the 
superintendent.; 
D. A carrier shall reimburse an out-of-network provider for ambulance services that 
are covered emergency services at the out-of-network provider's rate, unless the 
carrier and out-of-network provider agree otherwise. 
This paragraph is repealed October 1. 2021: 
E. If an out-of-network provider disagrees with a carrier's payment amount for a 
s:µ.rprise bill for emergency services or for covered emergency services as determined 
in accordance with paragraph B, the carrier and the out-of-network provider have 30 
calendar days to negotiate an agreement on the payment amount in good faith. If the 
carrier and the out-of-network provider do not reach agreement on the payment 
amount within 30 calendar days, the out-of-network provider may submit a dispute 
regarding the paym,ent and receive another payment from the carrier determined in 
accordance with the dispute resolution process in section 4303-E, including any 
payment made pursuant to section 4303-E, suqsection 1. paragraph G: and 
F. The enrollee's responsibility for pa:yment for covered out-of-network emergency 
services must be limited so that if the enrollee has paid the enrollee's share of the 
charge as specified in the plan for in-network services, the carrier shall hold the 
enrollee harmless from any additional amount owed to an out-of-network provider for 
covered emergency services and make payment to the out-of-network provider in 
accordance with this section or. if there is a dispute. in accordance with section 
4303-E. 
3. 
Payment after resolution of disputes. 
Following an independent dispute 
resolution determination pursuant to section 4303-E, the determination by the 
independent dispute resolution entity of a reasonable payment for a specific health care 
service or treatment rendered by an out-of-network provider is binding on a carrier, out-
of-network provider and enrollee for 90 days. During that 90-day period, a carrier shall 
reimburse an out-of-network provider at that same rate for that specific health care 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" 4,, to H.P. 1501, L.D. 2105 
service or treatment, and an out-of-network provider may not dispute any bill for that 
service under section 4303-E. 
Sec. 3. 24-A MRSA §4303-E is enacted to read: 
§4303-E. Dispute resolution process for surprise bills and bills for out-of-network 
emergency services 
1. Independent dispute resolution process. The superintendent shall establish an 
independent dispute resolution process by which a dispute for a surprise bill for 
emergency services or a bill for covered emergency services rendered by an out-of-
network provider in accordance with section 4303-C, subsection 2 may be resolved as 
provided in this subsection beginning no later than October 1, 2020. 
· 
· 
A. The superintendent may select an independent dispute resolution entity to conduct 
the dispute resolution process. The superintendent shall adopt rules to implement a 
dispute resolution process that uses a standard arbitration form and includes the 
selection of an arbitrator from a list of qualified arbitrators developed pursuant to the 
rules. A qualified arbitrator must be independent: may not be affiliated with a carrier, 
health care facility or provider or any professional association of carriers. health care 
facilities or providers; may not have a personal. professional or financial conflict with 
any parties to the arbitration; and must have experience in health care billing and 
reimbursement rates. Rules adopted pursuant to this paragraph are routine technical 
rules as defined in Title 5. chapter 375. subchapter 2-A. 
B. An independent dispute resolution entity shall make a decision within 30 days of 
receipt of the dispute for review. 
C. 
In determining a reasonable fee for the health care services rendered, an 
independent dispute resolution entity shall select either the carrier's payment or the 
out-of-network provider's fee. The independent dispute resolution entity shall 
determine which amount to select based upon the conditions and factors set forth in 
this paragraph~ 
In determining the reasonable fee for a health care service. an 
independent dispute resolution entity shall consider all relevant factors, including: 
(1) The out-of-network provider's level of training, education, specialization, 
quality and experience and, in the case of a hospital, the teaching staff, scope of 
services and case mix: 
(2) The out-of-network provider's previously contracted rate with the carrier, if 
the provider had a contract with the carrier that was terminated or expired within 
one year prior to the dispute; and 
(3) The median network rate for the particular health care service performed by a 
provider in the same or similar specialty, as determined by the all-payer claims 
database maintained by the Maine Health Data Organization or. if Maine Health 
Data Organization claims data is insufficient or otherwise inapplicable, another 
independent medical claims database. If authorized by rule, the superintendent 
may enter into an agreement to obtain data from an independent medical claims 
database to carry out the functions of this subparagraph. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT .. ;J, to H.P. 1501, L.D. 2105 
D. If an independent dispute resolution entity determines, based on the carrier's 
payment and the out-of-network provider's fee, that a settlement between the carrier 
and out-of-network provider is reasonably likely, or that both the carrier's payment 
and the out-of-network provider's fee represent unreasonable extremes, the 
independent dispute resolution entity may direct both parties to attempt a good faith 
negotiation for settlement. The carrier and out-of-network provider may be granted 
up to 10 business days for this negotiation, which runs concurrently with the 30-day 
period for dispute resolution. 
E. The determination of an independent dispute resolution entity is binding on the 
carrier, out-of-network provider and enrollee and is admissible in any court 
proceeding between the carrier, out-of-network provider and enrollee or in any 
administrative proceeding between this State and the provider. 
F. When an independent dispute resolution entity determines the carrier's payment is 
reasonable, payment for the dispute resolution process is the responsibility of the out-
of-network provider. When the independent dispute resolution entity determines the 
out-of-network provider's fee is reasonable, payment for the dispute resolution 
process is the responsibility of the carrier. When a good faith negotiation directed by 
the independent dispute resolution entity results in a settlement between the carrier 
and the out-of-network provider, the carrier and the out-of-network provider shall 
evenly divide and share the prorated cost for dispute resolution. 
G. 
When the difference between the out-of-network provider's charge and the 
median network rate pursuant to section 4303-C, subsection 2. paragraph B. 
subparagraph (1). including any applicable enrollee cost sharing, is less than $750, a 
carrier shall reimburse the out-of-network provider directly for the provider's charges 
for the services rendered as long as the provider's charges do not exceed the 80th 
percentile of charges for the particular health care service performed by a health care 
professional in the same or similar specialty and provided in the same geographical 
area as reported in a benchmarking database specified by the superintendent and 
maintained by a nonprofit organization that is not affiliated with and does not receive 
funding from a carrier. An out-of-network provider may dispute more than one bill 
with the same carrier for the same health care service under this subsection as long as 
the total of the bills with that carrier for that health care service exceeds $750. 
H. The superintendent shall enforce the determination of an independent dispute 
resolution entity pursuant to this subsection or any agreement made by a carrier and 
an out-of-network provider after the conclusion of the independent dispute resolution 
process pursuant to this subsection. The superintendent may use any powers provided 
to the superintendent under this Title. 
2. Self-insured health benefit plans. An entity providing or administering a self-
insured health benefit plan exempted from the applicability of this section under the 
federal Employee Retirement Income Security Act of 1974, 29 United States Code, 
Sections 1001 to 1461 (1988) may elect to be subject to the provisions of this section to 
resolve disputes with respect to a surprise bill for emergency services or a bill for covered 
emergency services from an out-of-network provider. In the event an entity providing or 
administering a self-insured health benefit plan elects to be subject to the provisions of 
this section, the provisions of this section apply to a self-insured health benefit plan and 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "/J• to H.P. 1501, L.D. 2105 
its members in the same manner as the provisions of this section apply to a carrier and its 
enrollees. To elect to be subject to the provisions of this section, the entity shall provide 
notice, on an annual basis. to the superintendent, on a form and in a manner prescribed by 
the superintendent. attesting to the entity's participation and agreeing to be bound by the 
provisions of this section. The entity shall amend the health benefit plan. coverage 
policies, contracts and any other plan documents to reflect that the provisions of this 
section apply to the plan's members. 
3. Information required from carriers. As part of the carrier's annual public 
regulatory filings made to the superintendent, a carrier shall submit in a form and manner 
determined by the superintendent information related to: 
A. The use of out-of-network providers by enrollees and the impact on premium 
affordability and benefit design; and 
B. The number of claims submitted by a provider to the carrier that are denied or 
down coded by the carrier and the reason for the denial or down coding 
determination. 
4. Report from superintendent. On or before January 31st annually. beginning 
January I. 2022. the superintendent shall report the following information received from 
all carriers in the aggregate: 
A. The number of requests for independent dispute resolution filed pursuant to this 
section between January 1st and December 31st of the previous calendar year, 
including the percentage of all claims that were subject to dispute. For each 
independent dispute resolution determination, the carrier shall provide aggregate 
information that does not identify any provider, carrier, enrollee or uninsured patient 
involved in each determination about: 
(1) 
Whether the determination was in favor of the carrier, out-of-network 
provider or uninsured patient; 
(2) 
The payment amount offered by each side of the independent dispute 
resolution process and the award amount from the independent dispute resolution 
determination: 
(3) 
The category and practice specialty of each out-of-network provider 
involved. as applicable; and 
(4) A description of the health care service that was subject to dispute: 
B. The percentage of facilities and hospital-based professionals, by specialty. that are 
in network for each carrier in this State as reported in access plans submitted to the 
superintendent: 
C. The number of complaints the superintendent receives relating to out-of-network 
health care charges; 
D. Annual trends on health benefit plan premium rates, the total annual amount of 
spending on inadvertent and emergency out-of-network costs by carriers and medical 
loss ratios in the State to the extent that the information is available; 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT 'A" to H.P. 1501, L.D. 2105 
E. The number of physician specialists practicing in the State in a particular specialty 
and whether they are in network or out of network with respect to the carriers that 
administer the state employee group health plan under Title 5, section 285, the Maine 
Education Association benefits trust health plan, the gualified health plans offered 
pursuant to the federal Affordable Care Act and other health benefit plans offered in 
the State: 
F. 
A summary of the information submitted to the superintendent pursuant to 
subsection 3 concerning the number of claims submitted by health care providers to 
carriers that are denied or down coded by the carrier and the reasons for the denials or 
down coding determinations; 
G. An analysis of the impact of this section, with respect to both emergency services 
and other health care services, on premium affordability and the breadth of provider 
networks; and 
H. 
Any other benchmarks or information that the superintendent considers 
appropriate to make publicly available to further the goals of this section. 
The superintendent shall submit the report to the joint standing committee of the 
Legislature having jurisdiction over health insurance matters and shall post the report on 
the bureau's publicly accessible website. 
Sec. 4. 24-A MRSA §4320-C, as amended by PL 2019, c. 238, §3, is further 
amended to read: 
§4320-C. Emergency services 
If a carrier offering a health plan provides or covers any benefits with respect to 
services in an emergency facility or setting, the plan must cover emergency services 
without prior authorization. Cost-sharing requirements, eJ(pressed such as a deductible, 
copayment amount or coinsurance rate, for out-of-network services are the same as 
requirements that would apply if such services were provided in network, and any 
payment made by an enrollee pursuant to this section must be applied to the enrollee's in-
network cost-sharing limit. The enrollee's responsibilit:( for payment for covered out-of-
network emergency services must be limited so that if the enrollee has paid the enrollee's 
share of the charge as specified in the plan for in-network services, the carrier shall hold 
the enrollee harmless from any additional amount owed to an out-of-network provider for 
covered emergency services and make payment to the out-of-network provider in 
accordance with section 4303-C or, if there is a dispute, in accordance with section 
4303-E. 
A carrier offering a health plan in this State shall also comply with the 
requirements of section 4304, subsection 5. 
Sec. 5, Review of reimbursement rates for ambulance services. 
The 
Emergency Medical Services' Board shall convene a stakeholder group, including the 
Maine Ambulance Association, representatives of municipal and private ambulance 
services, health insurance carriers and the Department of Professional and Financial 
Regulation, Bureau of Insurance, to review issues related to reimbursement rates for 
ambulance services. The stakeholder group shall: 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT •A "to H.P. 1501, L.D. 2105 
1. 
Consider current reimbursement rates paid by carriers and other payors for 
ambulance services for ambulance providers participating in carrier networks and for 
ambulance providers that are out of network; 
2. Consider the reimbursement rates required under the Maine Revised Statutes, Title 
24-A, section 4303-C for emergency services rendered by out of network providers and 
the availability of the dispute resolution process under Title 24-A, section 4303-E to those 
providers; 
3. 
Determine the ambulance providers that participate in carrier networks and 
identify any barriers to participation in those networks; and 
4. Develop recommendations for improving the participation of ambulance services 
in carrier networks, including proposals to provide assistance with contract negotiation or 
to amend the reimbursement rates required under law. 
The Emergency Medical Services' Board shall submit a report, including any 
recommendations, to the joint standing committee of the Legislature having jurisdiction 
over health coverage, insurance and financial services matters no later than February 1, 
2021. The joint standing committee may report out a bill based on the report to the First 
Regular Session of the 13 0th Legislature. 
Sec. 6. Appropriations and allocations. The following appropriations and 
allocations are made. 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Administrative Services - Professional and Financial Regulation 0094 
Initiative: Provides allocation in fiscal year 2020-21 for software development. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
2019-20 
$0 
$0 
Administrative Services - Professional and Financial Regulation 0094 
2020-21 
$25,000 
$25,000 
Initiative: Provides allocation to establish one part-time Insurance Actuarial Assistant 
position and All Other costs beginning October 1, 2020. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Insurance - Bureau of 0092 
2019-20 
$0 
$0 
2020-21 
$2,616 
$2,616 
Initiative: Provides allocation to establish one part-time Insurance Actuarial Assistant 
position and All Other costs beginning October 1, 2020. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT •A,, to H.P. 1501, L.D. 2105 
OTHER SPECIAL REVENUE FUNDS 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
PROFESSIONAL AND FINANCIAL 
REGULATION, DEPARTMENT OF 
DEPARTMENT TOTALS 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
SUMMARY 
2019-20 
0.000 
$0 
$0 
$0 
2019-20 
$0 
$0 
2020-21 
0.500 
$39,605 
$6,684 
$46,289 
2020-21 
$73,905 
$73,905 
This amendment replaces the bill. 
The amendment amends the law providing 
consumer protection for surprise medical bills to include surprise bills for emergency 
services and also extends the same protections to bills for covered emergency services 
rendered by out-of-network providers. The amendment clarifies that consumers must be 
held harmless and not subject to balance billing for these services and specifies that 
consumers are responsible only for any applicable cost sharing determined as if the health 
care services were rendered by a network provider. 
In the event of a dispute with respect to only a surprise bill for emergency services or 
a bill for covered emergency services rendered by an out-of-network provider, the 
amendment directs the Superintendent of Insurance to develop an independent dispute 
resolution process to determine a reasonable payment for health care services beginning 
no later than October 1, 2020. 
The amendment requires the Emergency Medical Services' Board to convene a 
stakeholder group to review reimbursement rates for ambulance services. 
The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 03/16/20 Mac. 
LD 2105 
LR 2881(02) 
An Act To Protect Consumers from Surprise Emergency Medical Bills 
Fiscal Note for Bill as Amended by Committee Amendment uJ/,{ J/- 7~ 
Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
$0 
FY 2020-21 
$73,905 
Projections 
FY 2021-22 
Projections 
FY 2022-23 
Appropriations/ Allocations 
Other Special Revenue Funds 
$62,260 
$65,643 
Transfers 
Other Special Revenue Funds 
$0 
$0 
$0 
$0 
Fiscal Detail and Notes 
This bill requires the Department of Professional and Financial Regulation (DPFR), Bureau oflnsurance, to develop 
an independent dispute resolution process for disputes regarding surprise medical bills. It includes an ongoing Other 
Special Revenue Funds allocation in fiscal year 2020-21 of $48,905 for one part-time position and associated all other 
costs and includes a one-time allocation in fiscal year 2020-21 of $25,000 for the development of software necessary 
for the dispute resolution process. The DPFR has sufficient resources to fund the allocations. 
Additional costs to the State Employee Health Plan are expected to be minor and can be absorbed within existing 
budgeted resources. Additional costs to the Department of Public Safety associated with the Maine Emergency 
Medical Services' Board convening a stakeholder group and reporting the results can be absorbed within existing 
budgeted resources. 
LR2881(02) -Fiscal Note - Page 1 of 1