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Dear Neighbor,
The second session of the 131st Legislature is now well underway, and I’m back at the State House Monday through Thursday. Over the next few months, we will consider hundreds of bills before adjourning in mid-April.
Last year, we prioritized investing in the wellbeing of Maine workers and families, which included boosting affordable housing production, increasing funding for Pre-K and child care support and creating a statewide paid family and medical leave program. This year, we will look to build on these successes and work to address the challenges facing everyday Mainers.
I continue to have the privilege of serving on the Health Coverage, Insurance and Financial Services (HCIFS) Committee, as well as the Inland Fisheries and Wildlife (IFW) Committee.
On the HCIFS Committee, my colleagues and I are working on several exciting pieces of legislation.
LD 1498, as amended, establishes a process for medical practices with six or fewer providers to file complaints with and receive assistance from the Bureau of Insurance when experiencing unnecessary billing hurdles. Many mental health providers have small or independent practices with minimal administrative support, and private insurance companies routinely make billing for care so challenging that many practices stop taking insurance. Consequently, more individuals unable to pay out of pocket end up in emergency rooms, shelters and the criminal justice system. My hope is that the passage of LD 1498 will help protect patient access to affordable mental health care and reduce administrative burdens for all small medical practices.
LD 796 as amended, would improve the administrative process of prior authorization for medical professionals. Prior authorization is a system set up by insurance companies – public and private – to provide a health-plan cost control process. If a patient's treatment or test is deemed too costly, the insurance company will review whether it is medically necessary for the patient or if a less expensive test or treatment should be tried first. They will then decide whether to approve the course of treatment or reject it. Studying how many initial approvals, denials, and appeals insurance companies are issuing will illuminate whether they are delivering benefits to customers as promised.
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