24-A §4303-G. Provider maintenance of certification requirements (WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29) (WHOLE SECTION TEXT REPEALED 4/1/29)

(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)

(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29)

(WHOLE SECTION TEXT REPEALED 4/1/29)

The following provisions govern maintenance of certification requirements. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Hospital" means a hospital licensed and operating under Title 22, chapter 404 or 405 or the parent of such institution, or a hospital subsidiary or hospital affiliate in this State that provides medical services or medically related diagnostic and laboratory services or engages in ancillary activities supporting those services. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] B. "Maintenance of certification program" means satisfactory participation in a program beyond the continuing medical education requirements currently in place by the Board of Licensure in Medicine or Board of Osteopathic Licensure, or initial board certification by a national or regional medical specialty board. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] C. "Outpatient clinical practice" means any medical practice, home care or hospice organization or other nonhospital entity providing medical care through physicians. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] D. "Physician" means an individual licensed under Title 32, chapter 36 or 48 . [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

2. Discrimination prohibited. A carrier offering a health plan in this State may not: A. Deny reimbursement to a physician, hospital or outpatient clinical practice for services rendered because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] B. Provide lower reimbursement for services rendered by a physician, hospital or outpatient clinical practice because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] C. Prohibit a physician, hospital or outpatient clinical practice from participating in any of the carrier's provider networks because a physician does not participate in a maintenance of certification program; or [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] D. Determine credentialing of a physician, hospital or outpatient clinical practice based on the status of a physician's, hospital's or outpatient clinical practice's participation in a maintenance of certification program. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

3. Repeal. This section is repealed April 1, 2029. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]