To the patients of Camden Whole Health –
A public hearing for bill LD 1030 “An Act To Require Nondiscrimination Policies in Providing Health Care Services” has been scheduled for Tuesday, April 4, 2017 at 1:00PM located in the Cross Building, Room 220 in Augusta.
This bill is designed to increase patient choice, access, and equitable insurance reimbursement.
Thousands of patients in Maine are being denied services for essential health benefits.
Licensed healthcare providers that offer lower cost, less invasive, and prevention-focused care are often excluded from insurance provider networks entirely, reimbursed at different rates than conventional providers, made subject to different deductibles or copays, subjected to annual caps on services, or otherwise treated differently as “specialists”. The result is that patients are effectively being denied access to the licensed provider of their choice.
Senator Justin Chenette has introduced LD 1030, An Act To Require Nondiscrimination Policies in Providing Health Care Services. This bill is needed to correct such discriminatory insurance practices in Maine. It will:
• Prohibit insurers from excluding from in-network participation any category of licensed healthcare providers that are acting within the scope of their license or certification
• Prohibit health insurance plans from covering a given service when offered by one type of licensed provider while denying coverage from the same service when provided by another type of licensed provider
It’s important to note that the bill addresses the types of providers that must be included by insurers in a network – it does not call for an increase in the types of services covered by plans.
The bill will, however:
• Ensure reimbursement for services covered by a health plan and delivered within provider’s scope of practice
• Equally apply copays, deductibles, conversion factors, and covered essential benefits
• Ensure provider availability under network adequacy rules
• Create a transparent process for claim denials and appeals
• Apply to all plans in the state (self-insured, third-party administered, workers comp, any healthcare programs, and auto insurance carriers)
We are currently looking for patients to testify at the upcoming hearing about their personal experiences with insurance companies and getting services covered.
If you would be willing to testify and can make the meeting on April 4th, please let Dr. Deb or Dr. Barb know and we can provide you with the contact information of the person organizing support of this bill.