Sen. Tepler introduces bill to better understand consumer’s health insurance experience

AUGUSTA – On Tuesday, April 8, Sen. Denise Tepler, D-Topsham, introduced a bill to require health insurance carriers to provide data on why some consumer’s health insurance claims are denied. LD 910, “An Act to Collect Data to Better Understand the Consumer’s Health Insurance Experience,” was the subject of a public hearing before the Legislature’s Committee on Health Coverage, Insurance and Financial Services.

“When insurers deny patient claims, it places an enormous burden on families and their budgets,” said Sen. Tepler. “LD 910 will look into the reasons why health insurance claims are being denied, as well as help policymakers better understand how to improve coverage and better protect consumers from erroneous claim denials in the future.”

LD 910 would require the Superintendent of Insurance to identify the number of claims that were denied on a quarterly and annual basis, the five most commons reasons for claim denial and the five most commons reasons for a prior authorization denial.

“This bill is important because revealing the number of denials and why they were denied empowers consumers and clinicians,” said Anne Sedlack, Director of Advocacy at Maine Medical Association. “This publicly available data supports a more efficient, equitable and patient-centered healthcare system.”

LD 910 faces a work session and further action in committee.

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