The Consumer Health Law Program
"Helping Maine consumers get
the health care they need."

The Consumer Health Law Program is a program of Consumers for Affordable Health Care (CAHC) Foundation, a non-profit organization based in Augusta, Maine. CAHC Foundation is a Maine public charity whose mission is to assist people in obtaining affordable quality health care. Hear what consumers have to say about the Health Law Program!

WHAT WE DO:

The Consumer Health Law Program is a non-profit legal assistance program that primarily helps Maine families and individuals resolve disputes with their insurance companies. Our staff of attorneys provide free legal assistance in the following areas to help you . . .

• Obtain covered medically necessary services
• Negotiate with insurance companies over pre-authorization or continuation of services.
• Review options for affordable health insurance
• Interpret insurance policy provisions
• File appeals and grievances
• Represent families and individuals before insurance company appeal committees.
  

If you would like more information or you think you might need our services, contact Consumers for Affordable Health Care Foundation at 1-800-838-0388 or 622-7083 and ask to speak to someone in the Health Law Program.

You can also email us

FOR HEALTH CARE PROVIDERS

The Consumer Health Law program is here to help providers serve their patients. You can help us by:

• Referring individual patients who may have been wrongfully denied benefits.
• Notifying us of any patterns you observe in a health plan's denial of benefits.

WHAT OUR CLIENTS SAY ABOUT US:

"I had been having a very hard time getting my managed care company to cover my daughter's medical expenses. I filed a grievance on my own and was scheduled to attend a grievance hearing without having a lawyer present. I was extremely concerned about presenting my case properly. Fortunately, I learned about the Consumer Health Law Program shortly before the hearing. A staff attorney from the program came to my assistance with only a few days notice and represented me at the hearing. He gathered together all of the important documents and presented them at the hearing. It was a great relief having the support of an attorney handling my case."

--Kerry S., Old Town, Maine

"The staff at the Consumer Health Law Program has been a great help during a very difficult time in my life. My husband needed a neuropsychological exam following a stroke to assess the nature of the damage. Our managed care company refused to authorize the exam and, in the process, gave us the worst possible runaround - one excuse after another. We contacted the Consumer Health Law Program and one of their attorneys immediately contacted my husband's doctor and obtained additional information concerning the exam. With this information, he appealed the company's decision. The company authorized the exam one day after receiving the attorney's appeal letter."

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--Pat M., Auburn, Maine

Health Law Resources on the Web:

Check out the chapter Private Insurance in our Guide to Health Care for Maine People.

The Maine Bureau of Insurance web site contains useful information about the laws and regulations governing health insurance companies as well as information on current issues in the health insurance market.

The Bureau of Insurance has a Frequently Asked Questions page that answers some basic questions about health insurance in Maine

The Bureau also has a number of publications available online. Particularly helpful are the guide to individual insurance, guide to resolving health insurance disputes, and guide to insurance for small businesses.

The Maine Secretary of State's web site has a directory of all the rules published by the Bureau of Insurance. Individuals rules can be downloaded from this page as Microsoft Word documents.

Specific rules of interest to health care consumers include:

Chapter 750 which standardizes health plans in Maine by requiring them to offer certain benefits.

Chapter 850 ("Health Plan Accountability") which establishes a number of consumer protections against unfair or harmful practices by HMOs and other insurers.

The National Health Law program provides a wealth of information on health law issues for the consumer and the advocate.

The National Senior Citizen Law Center "advocates nationwide to promote the independence and well-being of low-income elderly individuals, as well as persons with disabilities, with particular emphasis on women and racial and ethnic minorities."

Health Hippo is an extensive database of "policy and regulatory materials related to health care."

St. Louis University School of Law's Center for Health Law Studies maintains a directory of health law sites on the world wide web.

The National Center for Youth Law site contains information about health law issues specific to children and families. Check out their articles on Child and Adolescent Health

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