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contract must provide payments for the services of a center that | are not less than the level and amount of payment that the managed | care plan or the Dirigo Health Insurance Program would make for | services provided by an entity not defined as a federally qualified | health center. |
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| | Sec. C-2. 22 MRSA §3174-DD, as enacted by PL 2003, c. 469, Pt. A, | §6, is amended to read: |
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| §3174-DD. Dirigo Health coverage |
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| | The department may contract with one or more health insurance | carriers to purchase Dirigo Health Insurance Program coverage for | MaineCare members who seek to enroll through their employers | pursuant to Title 24-A, section 6910, subsection 4, paragraph B. | A MaineCare member who enrolls in a the Dirigo Health Insurance | plan Program as a member of an employer group receives full | MaineCare benefits through the Dirigo Health Insurance Program. | The benefits are delivered through the employer-based health | plan, subject to nominal cost sharing as permitted by 42 United | States Code, Section 1396o(2003) and additional coverage provided | under contract by the department. |
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| | Sec. C-3. 24-A MRSA §6903, sub-§§12 and 13, as enacted by PL 2003, c. | 469, Pt. A, §8, are amended to read: |
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| | 12. Participating employer. "Participating employer" means an | eligible business that contracts with Dirigo Health pursuant to | section 6910, subsection 4, paragraph B and that has employees | enrolled in the Dirigo Health Insurance Program. |
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| | 13. Plan enrollee. "Plan enrollee" means an eligible | individual or eligible employee who enrolls in the Dirigo Health | Insurance Program through Dirigo Health. "Plan enrollee" | includes an eligible employee who is eligible to enroll in | MaineCare. |
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| | Sec. C-4. 24-A MRSA §6906, as enacted by PL 2003, c. 469, Pt. A, | §8, is amended to read: |
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| §6906. Prohibited interests of board members and employees |
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| | Board members and employees of Dirigo Health and their spouses | and dependent children may not receive any direct personal | benefit from the activities of Dirigo Health in assisting any | private entity, except that they may participate in the Dirigo | Health Insurance Program on the same terms as others may under | this chapter. This section does not prohibit corporations or | other entities with which board members are associated by reason | of ownership or employment from |
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