An Act To Establish the Health Technology Clinical Committee
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 5 MRSA §12004-I, sub-§30-B is enacted to read:
30-B.
| Health Care |
|
Health Technology Clinical Committee |
|
Expenses Only |
|
24-A MRSA §6953 |
Sec. 2. 24-A MRSA §6951, sub-§6, as enacted by PL 2003, c. 469, Pt. A, §8, is amended to read:
6. Technology assessment; health technology and health care services. The forum shall conduct technology assessment reviews to guide the use and distribution of new technologies in this State establish a program to assess health technology and health care services that uses scientific evidence to make coverage determinations for participating state agencies that purchase health care with public funds, including, but not limited to, MaineCare, the state employee health insurance program and Dirigo Health. The program must include a process for selecting health technologies and health care services for assessment. The forum shall make recommendations to the certificate of need program under Title 22, chapter 103-A may contract with a 3rd party to conduct research and produce health technology assessments for use by the Health Technology Clinical Committee under section 6953.
Sec. 3. 24-A MRSA §6953 is enacted to read:
The Health Technology Clinical Committee, as established in Title 5, section 12004-I, subsection 30-B, referred to in this section as "the committee," shall make coverage determinations for the health technology and health care services assessment program described under section 6951, subsection 6 based on an assessment of a particular health technology or health care service that includes a review of scientific evidence of the relative safety, efficacy and cost of that health technology or service.
1. Members. The executive director, in consultation with participating state agencies described under section 6951, subsection 6, shall appoint 5 members to the committee. Members serve 3-year terms and serve until a successor is appointed. The members must be licensed health care providers appointed from a pool of those who have submitted letters of interest. The executive director shall consider the following qualifications in making appointments: A. Practitioner specialty type and use of health technologies;
B. Practice location and community knowledge;
C. Length of practice experience;
D. Knowledge of and experience with evidence-based medicine;
E. Medical quality assurance experience; and
F. Health technology assessment experience.
2. Duties of committee. The committee shall: A. Select health technology or health care services for review by considering nominations from participating state agencies described under section 6951, subsection 6, committee members and interested parties;
B. Determine the conditions, if any, under which a health technology or health care service will be included as a covered benefit in health care programs of participating state agencies described under section 6951, subsection 6;
C. Identify whether the determination is consistent with identified Medicare decisions and expert guidelines and, if decisions are inconsistent with those decisions and guidelines, specify the reasons and evidentiary basis;
D. Specify criteria for participating state agencies described under section 6951, subsection 6 to use when deciding whether a covered health technology or service is medically necessary; and
E. Publish final committee determinations on coverage of health technologies and health care services on a publicly accessible website within 10 days of each determination.
SUMMARY
This bill requires the Maine Quality Forum to establish a health technology assessment program to make determinations as to which health technologies and health care services will be included as covered benefits in publicly funded health care plans. The bill establishes the Health Technology Clinical Committee, a 5-member committee of health care providers, to conduct the assessments and make the coverage determinations based on reviews of scientific evidence.