Healthcare

LD 67 defines "urgent care facility" as a walk-in clinic providing non-life-threatening care, excluding hospital-licensed sites, overnight facilities, and private physician offices. It requires Maine's Department of Health and Human Services to establish licensing standards by July 1, 2026, including a fee between $50 and $500. The standards must cover staffing, care quality, advertising, inspections, complaint handling, and accreditation. These rules directly affect urgent care facilities meeting the defined scope, ensuring minimum operational and safety requirements. The bill creates a regulatory framework without specifying additional funding or penalties.

This bill requires Maine health insurance carriers to report quarterly on denied claims and prior authorizations starting in 2026. Carriers must track the number of denials and list the five most common reasons for both claim denials and prior authorization denials. The Superintendent of Insurance will compile these reports, along with federal data from the Affordable Care Act, into an annual report submitted to the relevant legislative committee by January 31 each year. The committee may then propose new legislation based on the findings to address patterns in insurance denials.