Resolve, Regarding
Maine Legislature, Session 132, LD 0270
Committee Amendment CA_A_H123 (House)

COMMITTEE AMENDMENT "-A " to H.P. 173, L.D. 270, "Resolve, Regarding 
Legislative Review of Portions of Chapter 850: Health Plan Accountability, a Major 
Substantive Rule of the Department of Professional and Financial Regulation, Bureau of 
Insurance" 
Amend the resolve by striking out all of section 1 and inserting the following: 
'Sec. 1. Adoption. Resolved: That final adoption of portions of Chapter 850: 
Health Plan Accountability, a provisionally adopted major substantive rule of the 
Department of Professional and Financial Regulation, Bureau of Insurance that has been 
submitted to the Legislature for review pursuant to the Maine Revised Statutes, Title 5, 
chapter 375, subchapter 2-A, is authorized only if the following changes are made: 
1. The rule is amended in Section 8(G)(l)(c)(i) to remove the requirement that a 
written adverse health care treatment decision include the name and title of the person or 
persons evaluating the appeal and replace it with a requirement that the decision attest to 
the credentials of the person or persons evaluating the appeal and that the person or persons 
evaluating the appeal were not involved in the initiai decision and a requirement that the 
carrier identify a point of contact by name, address and telephone number to answer 
specific questions from the enrollee; and 
2. The rule is amended in Section 9(B)(2)(b )(i) to remove the requirement that a 
written adverse benefit determination that does not involve a health care treatment decision 
include the name and title of the person or persons participating in the grievance review 
process and replace it with a requirement that the determination attest to the credentials of 
the person or persons participating in the grievance review process and that the person or 
persons participating in the grievance review process were not involved in the initial 
2 
determination and a requirement that the carrier identify a point of contact by name, address 
and telephone number to answer specific questions.from the enrollee.' 
Amend the resolve by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT A 
"to H.P. 173, L.D. 270 
• SUMMARY 
This amendment amends the resolve to authorize final adoption of portions of Chapter 
850: Health Plan Accountability, a major substantive rule of the Department of Professional 
and Financial Regulation, Bureau oflnsurance only if certain changes are made. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/10/25 LRL 
LD270 
LR 670(02) 
Resolve, Regarding Legislative Review of Portions of Chapter 850: Health Plan Accountability, a 
Major Substantive Rule of the Department of Professional and Financial Regulation, Bureau of 
Fiscal Detail and Notes 
Insurance 
~ 
Fiscal Note for Bill as Amended by Committee Amendment 'N' f ",. \ i) 
Committee: Health Coverage, Insurance and Financial Services~ 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Additional costs to the Department of Professional and Financial Regulation, Bureau of Insurance associated with the 
rnlemaking process can be absorbed within existing budgeted resources, 
LR0670(02) - Fiscal Note - Page 1 of 1