Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 365 - STANDARDS FOR INDEPENDENT DISPUTE RESOLUTION OF EMERGENCY MEDICAL SERVICE BILLS
Section 031-365-5 - Conflict of interest

Universal Citation: 02 ME Code Rules ยง 031-365-5

Current through 2024-38, September 18, 2024

1. No person may be selected as an IDRE if it owns or controls, is owned or controlled by, or is under common control with:

A. any national, state, or local illness, health benefit, or public advocacy group;

B. any national, state, or local society or association of hospitals, physicians, or other providers of health care services; or

C. any national, state, or local association of insurance carriers.

2. If an IDRE acquires control of, becomes controlled by, or comes under common control with any entity described in subsection 1, the IDRE shall notify the Superintendent in writing within three business days of the acquisition or exercise of control and shall consult with the Superintendent as to how to mitigate the conflict of interest.

3. Before accepting an IDR, an IDRE shall submit a sworn statement setting forth that the proposed arbitrator has no material financial, personal, or professional affiliation with:

A. any officer, director, or manager of the carrier;

B. any health care provider, physician's medical group, independent practice association, or provider of pharmaceutical products or services or durable medical equipment that provided or supplied the health care service that is the subject of the IDR;

C. the facility at which the health service was provided;

D. any officer, director, partner, or manager of the physician's medical group, independent practice association, or facility that provided the heath care service;

E. the developer or manufacturer of the principal health service that is the subject of the IDR;

F. the patient whose health care service is the subject of the IDR; or

G. any organization described in subsection 1.

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