An Act to Create an Advocacy and Complaint Process f6r' Health Care Providers Within the Bureau of Insurance,,
Maine Legislature, Session 131, LD 1498
Committee Amendment CA_A_H823 (House)

COMMITTEE AMENDMENT" A" to H.P. 953, L.D. 1498, "An Act to Create an 
Advocacy and Complaint Process f6r' Health Care Providers Within the Bureau of 
Insurance,, 
Amend the bill by striking out the title and substituting the following: 
'An Act to Create a Liaison Program and Complaint Process Within the Bureau of 
Insurance for Independent Health Care Providers' 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec, 1. 24-A MRSA c, 56-A, sub-c, 2-B is enacted to read: 
SUBCHAPTER 2-B 
INDEPENDENT HEALTH CARE PROVIDER ASSISTANCE 
§4329. Independent health care provider assistance 
1. Independent health care provider defined. For the purposes of this section, 
"independent health care provider" means an independent health care practitioner or group 
of independent health care practitioners with 6 or fewer health care practitioners. but does 
not include a health care practitioner employed by a hospital or health system or a group of 
health care practitioners that is owned or operated. in whole or in patt. by a hospital or 
health system. 
2, Liaison program. The bureau shall establish a liaison program, referred to in this 
section as "the program." to provide assistance to independent health care providers as set 
fmth in this section. 
3. Duties. The duties of the program include: 
Page I • 131LR1454(02) 
COMMITTEE AMENDMENT 
ROS 
-"" 
I 
COMMITTEE AMENDMENT" A" to H.P. 953, L.D. 1498 
A. Providing information to independent health care providers on how to contact the 
program for assistance through the bureau's publicly accessible website and through a 
toll-free number; 
B. Providing information to independent health care providers on the bureau's publicly 
accessible website regarding the State's health insurance laws and rules and the rights 
and responsibilities of carriers and health care providers; 
C. Assisting independent health care providers with inquiries related to the State's 
health insurance laws and rules; and 
D. Receiving information from independent health care providers regarding regulat01y 
or compliance issues that may have a market-wide impact. 
4. Provider complaint process. The bureau shall establish a process to receive and 
investigate complaints from independent health care providers regarding an alleged 
violation of any provision of this Title or any rule adopted pursuant to this Title. The bureau 
may also receive and investigate complaints from providers other than independent health 
care providers. 
5. Confidentiality, With respect to the program or complaints. records, 
correspondence and repo1is of investigation in collllection with actual or claimed violations 
of this Title or a rule adopted pursuant to this Title are confidential to the same extent as 
records. correspondence and reports of investigation of consumer complaints under section 
216. 
6. Procedures for data collection. The bureau may establish procedures for collecting, 
tracking and quantifying requests for assistance and complaints. 
7. 
Aggregate information. The bureau shall compile and publish aggregate 
information regarding complaints received under subsection 4 on its publicly accessible 
website. 
8, Staffing resources, The bureau may consider staffing resources and any limitations 
on those resources when establishing guidelines regarding the assistance provided through 
the program and complaint process, 
9, Rules. The bureau may adopt rules to implement this section. Rules adopted 
pursuant to this subsection are routine technical rules as defined in Title 5. chapter 375, 
subchapter 2-A, 
10, No legal representation, This section does not authorize the bureau to act as a 
legal representative of a provider or to provide assistance with contract negotiations or 
interpretations of the terms of contracts between providers and carriers in any mallller 
through the program or complaint process, 
Sec. 2. Appropriations and allocations. The following appropriations and 
allocations are made, 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Insurance - Bureau of 0092 
Initiative: Provides funding for one Senior Insurance Analyst position to manage the 
independent health care provider assistance liaison program and complaint process, 
OTHER SPECIAL REVENUE FUNDS 
2023-24 
2024-25 
COMMITTEE AMENDMENT 
ROS 
\ 
J 
II 
COMMITTEE AMENDMENT" p;,• to H.P. 953, L.D. 1498 
POSITIONS - LEGISLATIVE COUNT 
Personal Services 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
0.000 
$0 
$0 
$0 
1.000 
$100,788 
$15,725 
$116,513 
Amend the bill by relettering or renumbering any nonconsecutive Patt letter or section 
number to read consecutively. 
SUMMARY 
This amendment changes the title and replaces the bill. The amendment requires the 
Depa1tment of Professional and Financial Regulation, Bureau of Insurance to establish a 
liaison program to assist independent health care providers and to establish a process to 
receive and investigate provider complaints. The amendment limits the scope of ce1tain 
services to be provided by the bureau to an independent health care practitioner or group 
of independent health care practitioners with 6 or fewer health care practitioners and does 
not include a health care practitioner or group of health care practitioners that is owned or 
operated, in whole or in pait, by a hospital or health system. 
Under the liaison program, the amendment requires the bureau to assist independent 
health care providers in obtaining information about health insurance laws and rules and to 
receive concerns regarding regulatory or compliance issues that may have a market-wide 
impact. 
The amendment also requires the bureau to establish a process to receive and 
investigate complaints from independent health care providers regarding an alleged 
violation of any insurance law or rule and also authorizes the bureau to receive and 
investigate complaints from other providers. The amendment makes clear that the bureau 
is not authorized to act as a legal representative· of a provider or to provide assistance with 
contract negotiations or interpretations of the terms of contracts between providers and 
carriers in any manner through the liaison program or complaint process. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 02/07/24 ;:P,:?ae. 
LD 1498 
LR 1454(02) 
An Act to Create an Advocacy and Complaint Process for Health Care Providers Within the Bureau 
of Insurance 
Fiscal Note for Bill as Amended by Committee Amendment ''N' ( H- &2-3) 
Committee: Health Coverage, Insurance and Financial Services 
Appropriations/Allocations 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY2023-24 
$0 
FY 2024-25 
$116,513 
Projections 
FY 2025-26 
$114,047 
Projections 
FY 2026-27 
$120,485 
This bill includes an Other Special Revenue Funds allocation to the Department of Professional and Financial 
Regulation of $116,513 in fiscal year 2024-25 for one Senior hlsurance Analyst position to manage the independent 
health care provider assistance liason program and complaint process. 
LRl454(02) - Fiscal Note - Page I of I