An Act To Modify the Calculation and Implementation Date of Savings Offset Payments under the Dirigo Health Act
Maine Legislature, Session 122, LD 1577
Committee Amendment CA_A-HA_A_H681 (House)
Committee: Insurance and Financial Services

HOUSE AMENDMENT ,A" to COMMITTEE AMENDMENT 
L.D. 
1577, 
Bill, 
"An 
Act 
To 
Modify 
the 
Implementation Date of Savings Offset Payments 
Health Act" 
"A" to S.P. 555, 
Calculation 
and 
under the Dirigo 
Amend the amendment by striking out all of the emergency 
preamble. 
Further amend the 
amendment in Part A in section 5 by 
striking out all of subsection 12 and inserting in its place the 
following: 
'12. 
Report: 
jurisdiction. 
Dirigo Health shall 
report 
twice annually, once in January and once during the last month of 
the regular legislative session, to the joint standing committee 
of 
the 
Legislature 
having 
jurisdiction 
over 
insurance 
and 
financial services matters 
on the Dirigo Health Program 
and 
budget. 
Minutes of meetings of the Board of Directors of Dirigo 
Health must be provided to each member of the joint standing 
committees of the Legislature having jurisdiction over insurance 
and financial services matters, health and human services matters 
and appropriations and financial affairs.' 
Further amend the 
amendment in Part B in section 1 
by 
striking out all of subsections 2 and 3 (page 8, lines 19 to 48 
in amendment) and inserting in their place the following: 
'2. Conveninq of workinq qroup; schedule. The Superintendent 
of Insurance shall convene the first meeting of the working 
group. 
In order to complete its work in a timely fashion, the 
Page l-LR1479(5) 
HOUSE AMENDMENT 
HOUSE AMENDMENT If" to COMMITTEE AMENDMENT "A" to S. P • 555, L. D . 
1577 
working group may make 
time 
frames 
discussed 
its 
with 
recommendations in accordance with 
the 
Joint 
Standing 
Committee 
on 
Insurance and Financial Services. 
3. Duties. 
The working group shall make recommendations to 
advise the board on the following issues: 
A. 
The definition of "subsidy" within the Dirigo Health 
Program; 
B. The definition of "paid claims" for the purpose of using 
paid 
claims 
as 
the 
base 
for 
savings 
offset 
payment 
assessments 
on 
administrators 
health 
insurance 
carriers, 
3rd-party 
and 
employee 
benefit 
excess 
insurance 
carriers; 
C. The process for implementing and invoicing savings offset 
payment assessments based on the recommended definition of 
paid claims; 
D. 
The 
board's 
proposed 
methodology 
for 
calculating 
aggregate measurable cost savings. This recommendation must 
be made no later than September 20, 2005; and 
E. 
A 
funding 
strategy 
to 
cover 
Dirigo 
Health's 
administrative expenses. This recommendation must be made no 
later than December 31, 2005.' 
Further 
subsection 
inserting in 
amend the amendment in 
by striking out all of 
their place the following: 
Part 
B in 
paragraphs 
section 2 
A to 
C 
in 
and 
'A. 
No later than the effective date of this Act, the board 
shall 
file 
with 
the 
Superintendent 
of 
Insurance 
its 
determination as to the aggregate measurable cost savings in 
this State, including any reduction or avoidance of bad debt 
and charity care cost to health care providers as a result 
of 
the 
operation 
of 
Dirigo 
Health 
and 
any 
increased 
MaineCare 
enrollment 
due 
to 
an 
expansion 
in 
MaineCare 
eligibility occurring after June 30, 
2004 as well as the 
supporting information for that determination. 
The filing 
constitutes a public record; and 
B. 
Following a public hearing held in accordance with the 
Maine Administrative Procedure Act and no later than 6 weeks 
following the effective date of this Act, the Superintendent 
of Insurance shall issue an order approving, in whole or in 
part, or disapproving the filing made under paragraph A. 
The 
board is designated 
a 
party to 
the hearing. 
The 
superintendent shall approve the filing upon a determination 
HOUSE AMENDMENT 
HOUSE AMENDMENT ,A .. to COMMITTEE AMENDMENT "A" to S.P. 555, L.D. 
1577 
that the aggregate measurable cost 
board 
are 
reasonably 
supported 
by 
record. ' 
savings filed by the 
the 
evidence 
in 
the 
Further amend the amendment by inserting after Part C the 
following: 
Sec. 
D-l. 
Appropriations 
and 
allocations. 
appropriations and allocations are made. 
The 
following 
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Bureau of Insurance 0092 
Initiative: 
Allocates 
funds 
for 
the costs of 
reviewing 
and 
analyzing the Board of Directors of Dirigo Health filing of its 
determination as to the aggregate measurable cost savings from 
the operation of Dirigo Health and related MaineCare expansions. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
2005-06 
$50,000 
$50,000 
2006-07 
$0 
$0' 
Further 
amend the 
amendment by striking out all of the 
emergency clause. 
SUMMARY 
This amendment strikes the emergency preamble and emergency 
clause and accordingly adjusts certain dates within the bill as 
amended by Committee Amendment A. 
This 
amendment 
also 
replaces 
language 
in the 
committee 
amendment regarding legislative jurisdiction over Dirigo Health. 
This 
amendment also revises the deadlines for the first 
assessment year. 
HOUSE AMENDMENT 
HOUSE AMENDMENT "fl'.. to COMMITTEE AMENDMENT "A" to S.P. 555, L.D. 
1577 
This amendment also adds an appropriations and allocations 
section. 
SPONSORED BY: 
FISCAL :\OTE REQlilRED 
(See attached) 
(Represen a 
TOWN: 
Calais 
HOUSE AMENDMENT 
Approved: 06/1 0/05 ~aC!. 
LD 1577 
LR 1479(05) 
An Act To Modify the Calculation and Implementation Date of Savings Offset Payments under the 
Dirigo Health Act 
Fiscal Note for House Amendment 'A''' to Committee Amendment A" 
Sponsor: Rep. Perry 
Appropriations/Allocations 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
2004-05 
2005-06 
$50,000 
2006-07 
$0 
Projections 
2007-08 
$0 
Projections 
2008-09 
$0 
Assumes the Bureau of Insurance in the Department of Professional and Financial Regulation will require an 
additional Other Special Revenue Funds allocation of$50,000 for the one-time costs of reviewing and analyzing the 
Dirigo Health Board's filing of its determination as to the aggregate measurable cost savings from the operation of 
Dirigo Health and related MaineCare expansions. The allocation is needed for the costs of contracted external 
expertise the Bureau anticipates it will need. 
LR1479(5) - Fiscal Note - Page 1 of 1