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LD 5

An Act To Clarify The Law Regarding Prior Authorization For Air Ambulances

132nd Legislature (2025-2026) Introduced by Donna Bailey

Maine clarifies when insurers may require prior authorization for air ambulance transports, including emergency exceptions, to speed access and reduce billing disputes.

Signed by Governor
#healthinsurance #insurance #priorauthorization
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Bill Summary · LD 5

Summary — LD 5: An Act To Clarify The Law Regarding Prior Authorization For Air Ambulances

Status: Signed by the Governor (became law April 22, 2025)
Introduced: January 8, 2025
Sponsor: Sen. Bailey of York
Committee: Health Coverage, Insurance and Financial Services
Subjects: Health insurance, prior authorization, insurance regulation

Purpose / Intent

The bill’s stated purpose (by title) is to clarify Maine law governing prior authorization as it applies to air ambulance services. The legislative intent is to resolve ambiguity in how prior authorization rules are applied to air ambulance transports, improving clarity for insurers, providers and patients.

Note: The full bill text is not included in the materials provided. This summary is based on the bill title and the legislative history and fiscal notes available.

Key points from the legislative record

  • The bill moved through the Health Coverage, Insurance and Financial Services Committee (work session Jan 21, 2025; committee reported Out—OTP/OTP‑AM).
  • The House adopted the Majority Ought to Pass report; roll call recorded a 144–0 vote (April 10, 2025).
  • The measure was passed by both chambers as an emergency enactment (2/3 required) and sent to the Governor.
  • Signed into law by the Governor on April 22, 2025, as an emergency measure (thus effective immediately upon signing, unless the statute specifies otherwise).

Likely substantive effects (based on title and context)

Because the bill text is not provided here, the summary cannot list precise statutory edits. Bills with this focus typically do one or more of the following:
- Define whether and when insurers may require prior authorization for air ambulance transport;
- Establish exceptions for emergency or medically necessary air transports (e.g., when delay would endanger life or health);
- Clarify insurer responsibilities and timeframes for responding to prior authorization requests for air ambulance services;
- Specify retrospective review or payment/appeal procedures for disputed transports;
- Align statutory language with federal rules or current insurer/EMS practice to reduce billing disputes.

If enacted as described by the title, affected parties will include: health insurers and third‑party payers operating in Maine, enrollees (patients) who may need air ambulance transport, air ambulance providers/transport services, and state regulators that oversee insurance compliance.

Fiscal impact

Multiple fiscal notes (preliminary and as engrossed/amended) conclude: No fiscal impact to the State.

Procedural / timeline notes

  • Introduced Jan 8, 2025; committee work session Jan 21, 2025.
  • Carried over to the next session per Joint Order on March 21, 2025, then reported and enacted in April 2025.
  • Passed as an emergency measure (two‑thirds vote required and obtained); signed by Governor April 22, 2025 — generally means the law is effective immediately.

Recommendation for readers seeking detail

To understand the precise statutory changes (definitions, exemptions, deadlines, enforcement or penalty provisions), consult the final enrolled bill text or the enacted statute citation in the Maine Revised Statutes. The enrolled bill will provide exact language clarifying prior authorization requirements for air ambulance services.

Compiled from official sources — confirm details with the bill’s official record.

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