| | 1.__Dirigo Health Insurance.__Dirigo Health shall arrange for | the provision of health benefits coverage through Dirigo Health | Insurance.__Dirigo Health Insurance must comply with all relevant | requirements of this Title.__Dirigo Health Insurance may be | offered by health insurance carriers that apply to the board and | meet qualifications described in this section and any additional | qualifications set by the board.__If health insurance carriers do | not apply to offer and deliver Dirigo Health Insurance, the board | shall have Dirigo Health provide access to health insurance by | establishing a nonprofit health plan or through an existing | public plan.__To qualify as a carrier of Dirigo Health Insurance, | a health insurance carrier must: |
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| A.__Provide the comprehensive health services and benefits | as determined by the board, including a standard benefit | package and any supplemental benefits the board wishes to | make available; and |
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| (1)__Providers participating in Dirigo Health Insurance | do not charge plan enrollees or 3rd parties for covered | health care services in excess of the amount reimbursed | to that provider by Dirigo Health Insurance; and |
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| (2) Providers participating in Dirigo Health Insurance | do not refuse to provide services to a plan enrollee on | the basis of health status, medical condition, previous | insurance status, race, color, creed, age, national | origin, citizenship status, gender, sexual orientation, | disability or marital status. |
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| Health insurance carriers that seek to qualify to provide Dirigo | Health Insurance must also qualify as health plans in MaineCare. |
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| | 2.__Contracting authority.__Dirigo Health has contracting | authority and powers to administer Dirigo Health Insurance as set | out in this subsection. |
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| A.__Dirigo Health may contract with health insurance | carriers licensed to sell health insurance in this State or | other private or public 3rd-party administrators to provide | Dirigo Health Insurance.__In addition: |
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| (1)__Dirigo Health shall issue requests for proposals | from health insurance carriers; |
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| (2)__Dirigo Health may include quality control, disease | management and cost-containment provisions in the contracts with | participating health insurance carriers |
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