AUGUSTA – Governor Janet Mills has signed LD 1155, “An Act To Protect Patients and the Prudent Layperson Standard.” The bill, which was signed by the Governor on Friday, June 7, 2019, 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.
“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.”
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.