Code of Maine Rules
02 - DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
031 - BUREAU OF INSURANCE
Chapter 825 - PROCEDURES AND STANDARDS FOR OBTAINING A HARDSHIP EXEMPTION FROM SUBMITTING ELECTRONIC HEALTH CLAIMS
Section 031-825-1 - Purpose and Scope

This Rule is adopted by the Superintendent, pursuant to requirements of and authority set forth in 24M.R.S.A. §§2332-E, 2985 and 24-A M.R.S.A. §§ 1912, 2436, 2680, 2753, 2823-B, 4235, and 212, to establish procedures for health care practitioners to request exemptions to the requirement that they submit claims in electronic data format.

Title 24 M.R.S.A. §2985 requires health care practitioners who directly bill for health care services to submit claims in electronic data format to a carrier, as defined in 24-A, § 4301-A(3). Section 2985 provides that a health care practitioner or group of health care practitioners with fewer than 10 full-time equivalent employees is exempt until October 16, 2005. Beginning on that date, such practitioners and groups may apply to the Superintendent of Insurance for a continued exemption based upon hardship. The statute requires the Superintendent to adopt rules relating to the process for requesting a hardship exemption and the standards for determining whether a practitioner has demonstrated hardship.