An Act to Strengthen Maine's Health Care Workforce by Preventing Discrimination by Requiring Maintenance of Certification for Insurance Reimbursement
Maine Legislature, Session 131, LD 0224
Committee: Health Coverage, Insurance and Financial Services
Sponsors: ZAGER, BAILEY, ARFORD, GRAHAM, MASTRACCIO, CARNEY
Amends: 24-A MRSA §4303-G

Legislative Document
No. 224
H.P. 145
House of Representatives, January 20, 2023
An Act to Strengthen Maine's Health Care Workforce by 
Preventing Discrimination by Requiring Maintenance of 
Certification for Insurance Reimbursement
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative ZAGER of Portland.
Cosponsored by Senator BAILEY of York and
Representatives: ARFORD of Brunswick, GRAHAM of North Yarmouth, MASTRACCIO of 
Sanford, Senator: CARNEY of Cumberland.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4303-G is enacted to read:
§4303-G.  Provider maintenance of certification requirements
The following provisions govern maintenance of certification requirements.
1.  Definitions.  As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings.
A. "Hospital" means a hospital licensed and operating under Title 22, chapter 404 or 
or the parent of such institution, or a hospital subsidiary or hospital affiliate in this 
State that provides medical services or medically related diagnostic and laboratory 
services or engages in ancillary activities supporting those services.
B. "Maintenance of certification program" means satisfactory participation in a 
program beyond the continuing medical education requirements currently in place by 
the Board of Licensure in Medicine or Board of Osteopathic Licensure, or initial board 
certification by a national or regional medical specialty board.
C. "Outpatient clinical practice" means any medical practice, home care or hospice 
organization or other nonhospital entity providing medical care through physicians.
D. "Physician" means an individual licensed under Title 32, chapter 36 or 48.
2.  Discrimination prohibited.  A carrier offering a health plan in this State may not:
A. Deny reimbursement to a physician, hospital or outpatient clinical practice for 
services rendered because a physician does not participate in a maintenance of 
certification program;
B. Provide lower reimbursement for services rendered by a physician, hospital or 
outpatient clinical practice because a physician does not participate in a maintenance 
of certification program;
C. Prohibit a physician, hospital or outpatient clinical practice from participating in any 
of the carrier's provider networks because a physician does not participate in a 
maintenance of certification program; or
D. Determine insurance empanelment of a physician, hospital or outpatient clinical 
practice based on the status of a physician's, hospital's or outpatient clinical practice's 
participation in a maintenance of certification program.
Sec. 2.  Application. The requirements of this Act apply to a carrier as defined in the 
Maine Revised Statutes, Title 24-A, section 4301-A that executes, delivers, issues for 
delivery, continues or renews an individual or group policy, contract or certificate in this 
State on or after January 1, 2024.
SUMMARY
This bill prohibits carriers from conditioning reimbursement, provider network or 
empanelment status for a physician, hospital or outpatient clinical practice on a physician's, 
hospital's or outpatient clinical practice's participation in a maintenance of certification 
program.