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Maine law to require medical pros conduct insurance reviews

Maine law to require medical pros conduct insurance reviews

Photo: 560 WGAN Newsradio


AUGUSTA, Maine (AP) Insurance companies’ medical reviews of patients must be conducted by medical professionals under a new Maine law.

Democratic Gov. Janet Mills signed the proposal into law on Thursday. Mills’ office says the new law requires that appeals of a health insurance carrier’s denial of health care treatment be conducted by a licensed practitioner who is board certified in the proper specialty.

Mills says it’s important for medical professionals with the same training as a patient’s personal doctor conduct the reviews, and not insurance company officials. She says the law will protect families from having to justify a member’s need for medical care to “insurance company officials only looking out for the bottom line.”

Democratic Sen. Geoff Gratwick, of Bangor, proposed the law change. Gratwick is a retired doctor.

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