An Act To Establish Transparency in Primary Health Care Spending
Sec. 1. 22 MRSA §8702, sub-§8-D is enacted to read:
Sec. 2. 22 MRSA §8718 is enacted to read:
§ 8718. Primary care data
Sec. 3. 24-A MRSA §6903, sub-§13-B is enacted to read:
Sec. 4. 24-A MRSA §6951, sub-§12 is enacted to read:
Sec. 5. Maine Quality Forum to conduct health spending reporting study. The Maine Quality Forum, established in the Maine Revised Statutes, Title 24-A, section 6951, shall consult with other state and national agencies and organizations to determine the best practices for reporting spending on primary care services by insurers. For purposes of this section, "primary care" means general health care provided by a health care provider with whom the patient has initial contact for a health issue and by whom the patient may be referred to a specialist. By January 15, 2020, the forum shall submit a report containing its findings from the study and any recommended legislation to the Department of Health and Human Services and the Joint Standing Committee on Health and Human Services. The committee may report out legislation based upon the report to the Second Regular Session of the 129th Legislature.
This bill requires insurers to report primary care expenditures to the Maine Health Data Organization and for the Maine Quality Forum to use this data to report annually to the Department of Health and Human Services and the Legislature the percentage of total medical expenditures paid for primary care by commercial insurers, the MaineCare program, Medicare, the organization that administers health insurance for state employees and the Maine Education Association benefits trust respectively, the average of the percentage of total medical expenses paid for primary care across all organizations and the methods used by these organizations to pay for primary care. This bill also requires the Maine Quality Forum to conduct a study on best practices in health care spending reporting and submit its findings to the Department of Health and Human Services and the Joint Standing Committee on Health and Human Services.