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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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