Code of Maine Rules
90 - INDEPENDENT AGENCIES
351 - WORKERS' COMPENSATION BOARD
Chapter 15 - PENALTIES
Section 351-15-3 - Assessment of Penalties under 39-A M.R.S.A. section 205

1. Pursuant to 39-A M.R.S.A. §152(7), the Maine Workers' Compensation Board delegates to the Executive Director or the Executive Director's designee the authority to assess penalties pursuant to §§205(3) and 205(4). Complaints under §205(3) may be filed by the Deputy Director of Benefits Administration or other interested party. Any interested party may file a complaint pursuant to §205(4).

2. For complaints involving §205(3), the Abuse Investigation Unit will obtain documentation of payments made pursuant to §§205(1) and 205(2). Parties will be given the opportunity to address, in writing, any issues regarding factual disputes prior to the imposition of a penalty.

3. After completion of the investigation, if it is determined that a violation has occurred, the Executive Director or the Executive Director's designee will issue an order assessing penalties as outlined in §205(3). The order will specify the factual findings upon which the penalty is based.

4. For complaints involving §205(4), the complaint must specify that there is no ongoing dispute regarding the claim for benefits and must include proof of service upon the insurance carrier, by certified mail, of notice of nonpayment of the medical bill in question. Parties will be given the opportunity to address, in writing, any issues regarding factual disputes prior to the imposition of a penalty.

5. After completion of the investigation, if it is determined that a violation has occurred, the Executive Director or the Executive Director's designee will issue an order assessing penalties as outlined in §205(4). The order will specify the factual findings upon which the penalty is based.