LD 1239
pg. 7
Page 6 of 15 An Act Concerning Universal Health Insurance Page 8 of 15
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LR 186
Item 1

 
enrollees.__The plan shall develop objective criteria for the
selection of participating carriers and provide adequate notice
of the application process to permit all carriers a reasonable
and fair opportunity to participate.__The selection of
participating carriers must be based on the criteria developed
by the plan.

 
5.__Reinsurance; contracts.__The plan may contract with one
or more carriers to provide reinsurance or stop loss insurance
for coverage provided to eligible enrollees.__The plan shall
develop objective criteria for the selection of participating
reinsurers or stop loss insurers and provide adequate notice
of the application process to permit all reinsurers a
reasonable and fair opportunity to participate.__The selection
of participating carriers must be based on the criteria
developed by the plan.

 
6. Coordination with Medicaid. The plan shall maximize the
use of federal funds available through the Medicaid program to
provide health care coverage to all individuals enrolled in
the plan who are or could become eligible for Medicaid
pursuant to 42 United States Code, Section 1396a(r)(2), 1396u-
1 or 1397bb. For enrollees and dependents eligible for
Medicaid, health services provided by Medicaid must continue
to be provided in coordination with health services covered
under the plan.__The Department of Human Services shall apply
for any necessary federal Medicaid waivers to provide health
care coverage through the plan under this section.

 
7. Licensing; regulation.__Carriers, including reinsurance
carriers, that contract with the plan must be licensed
pursuant to this Title.__Health plans offered by participating
carriers must comply with all applicable provisions of this
Title and rules adopted pursuant to this Title.

 
§4164.__Maine Universal Health Care Agency

 
1. Administration.__The Maine Universal Health Care Agency
is established to administer and oversee the Maine Universal
Health Care Plan established in section 4163.__The agency
operates as an independent agency of the State within the
Executive Department.

 
2. Executive Director.__The Executive Director of the Maine
Universal Health Care Agency is appointed by the Governor,
subject to review by the joint standing committee of the
Legislature having jurisdiction over health insurance matters
and to confirmation by the Legislature, and serves at the
pleasure of the Governor.__The executive director must have
experience in the organization, financing and delivery of
health care.


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