Code of Maine Rules
90 - INDEPENDENT AGENCIES
590 - MAINE HEALTH DATA ORGANIZATION (MHDO)
Chapter 243 - UNIFORM REPORTING SYSTEM FOR HEALTH CARE CLAIMS DATA SETS


Current through 2024-13, March 27, 2024

SUMMARY: This chapter contains the provisions for filing health care claims data sets from all third-party payers, third-party administrators, Medicare health plan sponsors and pharmacy benefits managers.

The provisions include:

Identification of the organizations required to report;

Establishment of requirements for the content, format, method, and time frame for filing health care claims data;

Establishment of standards for the data reported; and

Compliance provisions.

STATUTORY AUTHORITY: 22 M.R.S. §§8703(1) , 8704(4) , 8708(6-A) and 8712(2)

The amended version of this chapter by filing 2023-249, eff. 12/17/2023 is not yet available.

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