LD 130
pg. 3
Page 2 of 22 An Act To Establish a Single-payor Health Care System Page 4 of 22
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LR 241
Item 1

 
G.__To distribute the costs of health care fairly and
equitably;

 
H.__To simplify the health care system for consumers,
businesses and providers;

 
I.__To ensure providers clinical freedom to treat patients
based on health care needs and criteria; and

 
J.__To ensure accountability in all aspects of the health
care system to promote public confidence and control of
costs.

 
2. Eligibility for Maine Health Care Plan.__In accordance with
this subsection, residents and nonresidents are eligible to
receive covered health care services from participating providers
under the plan within this State if the service is necessary or
appropriate for the prevention, diagnosis or treatment of, or
maintenance or rehabilitation following, injury, disability or
disease.__The agency shall adopt rules regarding payment of
premium, application for a plan card and membership in the plan.__
Rules adopted pursuant to this subsection are routine technical
rules as defined in Title 5, chapter 375, subchapter 2-A.__The
rules must provide for at least the following.

 
A.__Each resident of the State is eligible to receive health
care under the plan and may enroll in the plan.

 
B.__A nonresident of the State who maintains significant
contact with the State, including employment or self-
employment within the State or attendance at a college,
university or other institution of higher education in the
State, is eligible to receive health care under the plan.__
Eligibility extends to a person qualifying under this
paragraph and to that person's spouse and dependents.__The
agency shall adopt rules establishing criteria for
eligibility for nonresidents and determine the premium to be
paid by them and the method of payment.

 
C.__A plan member who ceases to be eligible for the plan may
elect, within 60 days of the event that causes ineligibility, to
continue participation in the plan for a period of up to 18
months.__For the purposes of this paragraph, a plan member is
considered to have lost eligibility due to disability if the
member could be determined disabled under the federal Social
Security Act, Title II or Title XVI.__The agency shall ensure
that plan members who become ineligible for enrollment in the
plan are promptly notified of the provisions of this paragraph.__
The


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