LD 1611
pg. 46
Page 45 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 47 of 47
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LR 2137
Item 1

 
B. "Health insurance provider" means any nonprofit health or
medical services organization as defined in the Maine Revised
Statutes, Title 24, any person engaged in the provision of
health insurance and any person engaged in the provision of
reinsurance for health insurers.

 
3. Voluntary limits on costs. The following constraints are
called for:

 
A. Each health care provider in this State is asked to
voluntarily restrain increases in the charges imposed and
the average payments assessed or accepted by that health
care provider for the health care services provided by that
health care provider to no more than 3% for a period of one
year following the effective date of this section; and

 
B. Each health care insurer licensed in this State is asked
to voluntarily limit the pricing of products sold in this
State to that level that supports no more than a 3%
underwriting gain for a period of one year following the
effective date of this section.

 
4. Compliance. The State shall monitor compliance with the
voluntary effort described in subsection 3. If, on a statewide
basis, average charges or average payments for health care
providers and average underwriting gain for insurance providers
exceed 3% for the one-year period following the effective date of
this section, the Governor's office shall develop plans for
implementation of provider rate-setting systems, global budgeting
systems and more stringent insurance rate regulation.

 
PART G

 
Sec. G-1. Medicare and veterans' health care. The Governor shall engage in
active negotiations with the Federal Government to increase
access to federally sponsored health services for veterans in
this State and to increase the rates of Medicare reimbursement
for the State's health care providers.

 
SUMMARY

 
Part A of the bill establishes Dirigo Health as an independent
agency of State Government. It seeks to make affordable health
insurance available to small businesses and individuals, provide
additional assistance to employees and individuals with earnings
below 300% of the federal poverty


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