LD 1611
pg. 32
Page 31 of 73 PUBLIC Law Chapter 469 Page 33 of 73
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LR 2137
Item 1

 
another entity for disease management services or provide disease
management services directly through Dirigo Health.

 
3.__Report.__Dirigo Health shall submit a report, no later
than January 1, 2006, outlining the disease management protocols,
procedures and delivery mechanisms used to provide services to
plan enrollees.__The report must also include the number of plan
enrollees in the high-risk pool, the types of diagnoses managed
within the high-risk pool, the claims experience within the high-
risk pool and the number and type of claims exceeding $100,000
for enrollees in the high-risk pool and for all enrollees in
Dirigo Health Insurance.__The report must be submitted to the
joint standing committee of the Legislature having jurisdiction
over health insurance matters.__The committee may make
recommendations on the operation of the high-risk pool and may
report out legislation to the Second Regular Session of the 122nd
Legislature relating to the high-risk pool.

 
4.__Establishment of statewide high-risk pool.__After 3 years
of operation, but no later than October 1, 2007, Dirigo Health
shall evaluate the impact of Dirigo Health on average premium
rates in this State and on the rate of uninsured individuals in
this State and compare the trends in those rates to the trends in
the average premium rates and average rates of uninsured
individuals for the 31 states that have established a statewide
high-risk pool as of July 1, 2003.__The board shall submit the
evaluation of the impact of Dirigo Health in this State in
comparison to states with high-risk pools to the joint standing
committee of the Legislature having jurisdiction over health
insurance matters by January 1, 2008. If the trend in average
premium rates in this State and rate of uninsured individuals
exceed the trend for the average among the 31 states with high-
risk pools, the board shall submit legislation on January 1, 2008
to the Second Regular Session of the 123rd Legislature that
proposes to establish a statewide high-risk pool in this State
consistent with the characteristics of high-risk pools operating
in other states.

 
Sec. A-9. Monthly report. The Department of Human Services shall
provide a monthly report of enrollment and expenditures for the
noncategorical adults enrolled in the MaineCare program under the
Maine Revised Statutes, Title 22, section 3174-G, subsection 1,
paragraph F. The report must include the number of members,
expenses and projections for expenses in the state fiscal year
for members enrolled under the expansion of income eligibility
from 100% of the nonfarm income official poverty line to 125% of
the nonfarm income official poverty line.

 
Sec. A-10. Determination of savings offset payments for third-party administrators.
The Governor's Office of Health


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