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LD378 Requires Health Insurer Compliance with Plan Sponsor Audit Rights

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Summary

Maine's LD378 was enacted on April 7, 2026, as an emergency measure requiring a two-thirds vote. The law mandates that health insurers must comply with plan sponsors' statutory rights to audit insurance claims and provide data requests related to those audits. The bill passed both chambers and takes effect immediately under the emergency designation.

What changed

LD378 enacts a new requirement that health insurers operating in Maine must comply with plan sponsors' statutory rights to audit insurance claims and provide data requests connected to those audits. The bill passed as an emergency measure, indicating immediate legislative urgency and requiring a two-thirds vote for enactment.\n\nHealth insurers must now facilitate audit access to claims data and allow plan sponsors to conduct or commission audits of claim records. Insurers should review and update their claims data management systems, compliance procedures, and contractual arrangements with third-party auditors to ensure they can promptly respond to audit requests. Failure to comply with audit facilitation obligations may expose insurers to regulatory enforcement under Maine's insurance laws.

What to do next

  1. Update internal claims audit procedures to comply with plan sponsor audit rights
  2. Establish processes to fulfill data requests related to claim audits
  3. Review contracts with third-party auditors to ensure audit facilitation capabilities

Archived snapshot

Apr 8, 2026

GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.

ChangeBridge / Maine / LD378 Passed LD378 LD Passed 2026-04-07

An Act to Clarify That Health Insurers Must Comply with Plan Sponsors' Statutory Rights to Audit Claims and Data Requests Related to Those Audits

Bill Details

State Maine

Session 132nd Legislature

Chamber House

Official Source legislature.maine.gov/legis/bills/display_...

LegiScan View on LegiScan

Sponsors

Donna Bailey (Sen - D)

Action History

2026-04-07 S PASSED TO BE ENACTED - Emergency - 2/3 Elected Required, in concurrence. 2026-04-07 H Sent for concurrence. ORDERED SENT FORTHWITH. 2026-04-07 H PASSED TO BE ENACTED. 2026-04-07 H This being an emergency measure, a two-thirds vote of all the members elected to the House was necessary. 2026-04-06 H In concurrence. ORDERED SENT FORTHWITH. 2026-04-06 H The Bill was PASSED TO BE ENGROSSED as Amended by Committee Amendment "A" (S-624). 2026-04-06 H Under suspension of the rules CONSENT CALENDAR - SECOND DAY. 2026-04-06 H CONSENT CALENDAR - FIRST DAY 2026-04-06 S Ordered sent down forthwith for concurrence. 2026-04-06 S Under suspension of the Rules, READ A SECOND TIME and PASSED TO BE ENGROSSED AS AMENDED BY Committee Amendment "A" (S-624). 2026-04-06 S Committee Amendment "A" (S-624) READ and ADOPTED. 2026-04-06 S READ ONCE. 2026-04-06 S Report READ and ACCEPTED. 2026-04-02 J Reported Out: OTP-AM 2026-03-18 J Voted: OTP-AM 2026-03-18 J Work Session Held 2025-06-25 S CARRIED OVER, in the same posture, to any special or regular session of the 132nd Legislature, pursuant to Joint Order SP 800. 2025-05-19 J Carry Over Approved 2025-05-16 J Carry Over Requested 2025-05-15 J Work Session Held: TABLED 2025-03-21 S CARRIED OVER, in the same posture, to the next special or regular session of the 132nd Legislature, pursuant to Joint Order SP 519. 2025-02-04 H In concurrence. ORDERED SENT FORTHWITH. 2025-02-04 H The Bill was REFERRED to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES. 2025-02-04 S Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES suggested and ordered printed REFERENCE to the Committee on HEALTH COVERAGE, INSURANCE AND FINANCIAL SERVICES Ordered sent down forthwith for concurrence

Committee Referrals

2025-02-04 J Health Coverage, Insurance and Financial Services

Amendments

0000-00-00 Senate: C-A (S-624) Adopted

Bill Text Versions

0000-00-00 Introduced

Subjects

Health Care Services Delivery Legislative data powered by LegiScan (CC BY 4.0)

Named provisions

Health Insurer Audit Compliance

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Last updated

Classification

Agency
Maine Legislature
Published
April 7th, 2026
Instrument
Rule
Legal weight
Binding
Stage
Final
Change scope
Substantive
Document ID
LD 378, 132nd Maine Legislature

Who this affects

Applies to
Insurers Healthcare providers
Industry sector
5241 Insurance
Activity scope
Health insurance claims Audit procedures Data requests
Geographic scope
US-ME US-ME

Taxonomy

Primary area
Insurance
Operational domain
Compliance
Compliance frameworks
Dodd-Frank
Topics
Healthcare Consumer Finance

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