LD 1577
pg. 11
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LR 1479
Item 1

 
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.

 
Sec. C-2. 22 MRSA §3174-DD, as enacted by PL 2003, c. 469, Pt. A,
§6, is amended to read:

 
§3174-DD. Dirigo Health coverage

 
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.

 
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:

 
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.

 
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.

 
Sec. C-4. 24-A MRSA §6906, as enacted by PL 2003, c. 469, Pt. A,
§8, is amended to read:

 
§6906. Prohibited interests of board members and employees

 
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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