State Payment for Medical Examinations or Certificates Effective September 30, 1989

DEPARTMENT OF ADMINISTRATIVE & FINANCIAL SERVICES
Bureau of Employee Relations
Telephone (207) 287-4447
FAX (207) 287-4452 TDD (207) 287-4537

No.: OSER-41

Date: October 4, 1989

Subject: State Payment for Medical Examinations or Certificates Effective September 30, 1989

To: All Holders of Employee Relations Manuals

From: Kenneth A. Walo, Director, Bureau of Employee Relations

A law enacted at the last legislative session will change one of the practices we have followed in state government. Past and current negotiated bargaining agreements provide that, in certain situations, the state may require a medical examination or doctor's certificate for employees who use sick leave. Prior to this time the examination or certificate has been at the employee's expense.

Public Law 1989, ch. 535 provides that, effective September 30, 1989, no employer may require any employee to bear the medical expense of an examination when that examination is ordered or required by the employer. Therefore, whenever a medical examination or medical certificate is required as delineated in the respective collective bargaining agreements or the Civil Service Rules the state must pay the medical expense for obtaining the certificate or examination.

Such payment may be made directly, through group health insurance coverage of the employee or otherwise, as long as the employee is not ultimately required to bear the expense of that examination. The cost of the examination or certificate may be covered by the employee's health insurance coverage.

To implement the new law the following procedure is to be utilized.

When the employee receives the medical bill he/she must complete the medical claim form and submit it to the insurance carrier. After the claim is considered and the explanation of benefits form is issued to the employee by the insurance carrier it should be presented to the departmental or agency designee to prove payment or nonpayment of the cost of the certificate or examination. The Department should then arrange to pay the unpaid balance of the expense of the certificate or examination. No payment should be made until the explanation of benefits form has been received and reviewed by the department or agency designee. Medical bills incurred by the employee which are not required for the certificate will not be paid by the State.

If you have any questions about the implementation or administration of this change as the result of the attached legislation please contact the Bureau of Employee Relations at 289-4447.

APPROVED CHAPTER

JUL 7 '89 535

By Governor Public Law

STATE OF MAINE

IN THE YEAR OF OUR LORD
NINETEEN HUNDRED AND EIGHTY-NINE

H.P. 534 - L.D. 731

An Act to Amend the Definition of
Employer to Include Governmental Entities

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

26 MRSA §592, as amended by PL 1985, c. 112, §2, is further amended to read:

§592. Charge by employer prohibited

No employer may require any employee or accepted applicant for employment to bear the medical expense of an examination when that examination is ordered or required by the employer. No employer may require any employee or accpeted accepted applicant for employment to bear the expense of an eye examination ordered or required by the employer which is performed by a person licensed to perform the examinations, except that if an employer orders or requires the eye examination to be performed by a specific type of eye care provider, or specific provider, the employer must pay for the examination only when performed by that specific type of eye care provider or specific provider. An employer may pay for an examination under this section directly, through group health insurance coverage of the employee or otherwise, as long as the employee is not ultimately required to bear the expense of that examination. Any employer who violates this section commits a civil violation for which a forfeiture not to exceed $50 for each and every violation may be adjudged. It is the duty of the director to enforce this section: Notwithstanding section 591, subsection 2, for the purpose of this section, the term "employer" includes the State, a county, a municipality, a quasi-municipal corporation or any other public employer. For the purposes of this section, the term "accepted applicant" means an applicant who has been offered a job by the employer.

1-1740(3)

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State Payment for Medical Examinations or Certificates Effective September 30, 1989