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B. Following a public hearing held in accordance with the | Maine Administrative Procedure Act and no later than 6 weeks | following the effective date of this Act, the Superintendent | of Insurance shall issue an order approving, in whole or in | part, or disapproving the filing made under paragraph A. The | board is designated a party to the hearing. The | superintendent shall approve the filing upon a determination | that the aggregate measurable cost savings filed by the board | are reasonably supported by the evidence in the record. |
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| | Sec. B-3. Funding Dirigo Health administrative expenses. General | administrative expenses of Dirigo Health, excluding | administrative expenses directly associated with the Maine | Quality Forum established in the Maine Revised Statutes, Title | 24-A, section 6951, may be covered by the remaining balance of | the $53,000,000 in funds transferred from the unappropriated | surplus of the General Fund to the Dirigo Health Fund pursuant to | Public Law 2003, chapter 469, Part H, section 1 and may not be | covered by savings offset payments in accordance with the Maine | Revised Statutes, Title 24-A, section 6913, subsection 2. | Following receipt and review of the recommendations of the | working group, established in section 1, regarding a funding | strategy for Dirigo Health's administrative expenses and no later | than February 15, 2006, the Board of Directors of Dirigo Health | shall submit its recommendations, including any suggested | legislation, for funding administrative expenses to the Joint | Standing Committee on Insurance and Financial Services. | Following receipt and review of the board's recommendation, the | committee may report out a bill related to funding Dirigo | Health's administrative expenses to the Second Regular Session of | the 122nd Legislature. |
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| | Sec. C-1. 22 MRSA §3174-V, sub-§2, as amended by PL 2003, c. 469, Pt. | A, §7, is further amended to read: |
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| | 2. Contracted services. When a federally qualified health | center otherwise meeting the requirements of subsection 1 | contracts with a managed care plan or the Dirigo Health Insurance | Program for the provision of MaineCare services, the department | shall reimburse that center the difference between the payment | received by the center from the managed care plan or the Dirigo | Health Insurance Program and 100% of the reasonable cost, reduced | by the total copayments for which members are responsible, | incurred in providing services within the scope of service | approved by the federal Health Resources and Services | Administration or the commissioner. Any such managed care |
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