LD378 Requires Health Insurer Compliance with Plan Sponsor Audit Rights
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
- Update internal claims audit procedures to comply with plan sponsor audit rights
- Establish processes to fulfill data requests related to claim audits
- Review contracts with third-party auditors to ensure audit facilitation capabilities
Archived snapshot
Apr 8, 2026GovPing 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_...
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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)
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