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PUBLIC LAWS OF MAINE
First Special Session of the 118th

CHAPTER 99
H.P. 179 - L.D. 234

An Act to Extend Access to Chiropractic Care under Health Maintenance Organization Managed Care Plans

Be in enacted by the People of the State of Maine as follows:

     Sec. 1. 24-A MRSA §4236, sub-§3, as enacted by PL 1995, c. 350, §1, is amended to read:

     3. Self-referrals for chiropractic care. A health maintenance organization must provide benefits to an enrollee who utilizes the services of a chiropractic provider by self-referral under the following conditions.

In the provision of chiropractic services under this subsection, a participating chiropractic provider is liable for a professional diagnosis of a mental or physical condition that has resulted or may result in the chiropractic provider performing duties in a manner that endangers the health or safety of an enrollee.
The provisions of this subsection apply to all health maintenance organization contracts, except a contract between a health maintenance organization and the State Employee Health Insurance Program.
This subsection takes effect January 1, 1996 and is repealed March 1, 1998.

     Sec. 2. Report required. The Bureau of Insurance shall submit a report to the joint standing committee of the Legislature having jurisdiction over insurance matters of the 119th Legislature by January 1, 1999 on the claims experience of health maintenance organizations related to self-referrals of chiropractic care under the Maine Revised Statutes, Title 24-A, section 4236. The report must include the total amount of claims paid for chiropractic services by health maintenance organizations, the total amount of claims paid for self-referred chiropractic services, the total number of self-referrals for chiropractic care, the average cost of those claims and the number of complaints received by the Bureau of Insurance regarding access to chiropractic care in health maintenance organization managed care plans.

See title page for effective date.

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