How a new law in Maine may affect payers' clinical review

Health insurers in Maine will face a new law in September that may change how they conduct medical reviews, according to ThinkAdvisor.

The bill, signed into law by Democratic Gov. Janet Mills, will require medical professionals to conduct medical reviews. Specifically, any appeal received by a health insurer in the state must be handled by a licensed provider who is board-certified in the specialty or a similar specialty related to the medical conditions, procedure or treatment in the claim.

"An appeal of a carrier's adverse healthcare treatment decision must be conducted by a clinical peer," according to the law, cited by ThinkAdvisor.

The law takes effect Sept. 17.

Read more here.

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