Maine Bureau of Insurance
Physician Performance Measurement,
Reporting, and Tiering Programs
Title 24-A MRSA §2694-A requires each insurer implementing or utilizing a physician performance measurement, reporting or tiering program to annually provide to the Superintendent a statement of the criteria, standards, practices, and procedures governing such a program.
Please complete the following form by October 1 of the current year. Applicants may be asked to provide such other information as the Bureau of Insurance may reasonably request.
If the insurer believes that it is exempt from this requirement, or that it has nothing to report related to utilization of a physician performance measurement/reporting/tiering program, please state the reason in box # 1. Once this reason is described, the rest of the form need not be completed.
If you have questions about completing the form, please contact Violet Hyatt at Violet.M.Hyatt@maine.gov or (207)-624-8550.