LD 1155, “An Act To Protect Patients and the Prudent Layperson Standard” , was enacted by the Senate earlier today

AUGUSTA – LD 1155, “An Act To Protect Patients and the Prudent Layperson Standard,” was enacted by the Maine Senate earlier today. The bill now heads to the Governor’s desk to be signed into law.

“No person should be put in the position of trying to self-diagnose or second guess when a medical emergency strikes,” said Speaker Gideon. “We must proactively protect Maine consumers and make sure that they are able to seek emergency medical care at the critical moment when they need it.”

LD 1155 strengthens existing law preventing  insurance companies from denying emergency room claims by requiring these companies to cover visits based on the patient’s presenting symptoms, not the final diagnosis.

The bill also strengthens existing law prohibiting a carrier from requiring prior medical authorization for emergency services. In several states, insurance companies have been warning policy holders that if their emergency department visit results in a diagnosis for something that the insurer doesn’t think was an emergency, the insurer will deny  or reduce the payment of the claim. This leaves the patient responsible for the bill.