02-031 C.M.R. ch. 360, § 10 - Examination of administrators who handle money

Current through 2022-14, April 6, 2022

A. The Superintendent or a designee may examine an administrator who directly or indirectly transfers funds, manages funds, adjusts claims, or asserts control over the transfer of funds for the purpose of payment of provider services for compliance with the requirements of this rule, 24-A M.R.S.A. §§2674-A and 1911.
B. Any administrator being examined shall provide to the examiner convenient and free access, at all reasonable hours at its offices, to all books, records, documents, and other papers relating to its business affairs. The examiner shall not have access to beneficiary medical records that are protected by state statute.
C. The examiners designated by the Superintendent pursuant to this Section may make reports to the Superintendent. Any report alleging substantive violations of this Rule, or any applicable provisions of the Maine Insurance Code, shall be in writing and be based upon facts obtained by the examiners. The report shall be verified by the examiner(s).
D. If a report is made, the Superintendent shall either deliver a duplicate thereof to the administrator being examined or send such duplicate by certified or registered mail to the administrator's address specified in the records of the Bureau. The Superintendent shall afford the administrator an opportunity to request a hearing to object to the report. As a result of the findings of the report, the Superintendent may initiate a hearing concerning revocation or suspension of registration if the findings of the report so indicate.

Notes

02-031 C.M.R. ch. 360, § 10

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