Governor Mills Signs Bill to Protect Patients in Insurance Reviews

Governor Janet Mills signed into law today legislation to ensure that insurance company medical reviews are conducted by medical professionals. LD 249, “An Act to Ensure Protection of Patients in Medical Reviews by Health Insurance Carriers” sponsored by Senator Geoff Gratwick, D-Bangor, was passed unanimously by the Legislature.

“After my late husband Stan suffered a stroke, insurance companies would sometimes deny claims for care without any explanation. It is an unfair, heartless practice that puts profits ahead of the patient’s wellbeing,” said Governor Mills. “Medical professionals with the same training as the patient’s own doctor should be conducting medical reviews for claims, not an insurance company official. By signing this legislation, we are taking steps to ensure that no family has to justify the need for their loved one’s medical care to insurance company officials only looking out for the bottom line. I thank Senator Gratwick for putting this legislation forward and for securing unanimous support in the Legislature.”

“When it comes to access to health care, our laws and our policies should always put patients before profits,” said Sen. Gratwick, a retired doctor who practiced medicine for 40 years. “The choice of what treatment to pursue, especially when that treatment is potentially life-saving, should be between a patient and their doctor, not the patient and an insurance provider. I’m glad the governor has signed this key protection into law.”

LD 249 requires that appeals of a health insurance carrier's denial of health care treatment be conducted by a licensed health care practitioner who is board certified in the same or similar specialty as the medical condition, procedure or treatment under review and whose compensation does not directly or indirectly depend upon the quantity, type or cost of the medical condition, procedure or treatment the practitioner approves or denies on behalf of a health insurance carrier.

Governor Mills also signed the following into law Thursday: