ME LD1152

Requires health insurers to offer small group health plans that incentivize enrollees to shop for low-cost, high-quality providers, removing the previous requirement that such plans be compatible with health savings accounts

Mandates incentives (cash payments, gift cards, premium/copay reductions) equal to at least 25% of the difference between the selected provider's price and the statewide average for the same service

Adds surgical procedures to the list of comparable health care services eligible for shopping incentives, alongside physical/occupational therapy, radiology/imaging, laboratory services, and infusion therapy

Extends out-of-network provider benefits to health maintenance organization (HMO) enrollees, who were previously excluded from provisions allowing services from lower-cost out-of-network providers

Removes geographic restrictions that previously limited out-of-network providers to those in Maine, Massachusetts, or New Hampshire who participate in MaineCare and Medicare