An Act To Establish the Hospital and Health Care Provider Cooperation Act
Maine Legislature, Session 122, LD 2110
Committee Amendment CA_A_S654 (Senate)

COMMITTEE AMENDMENT "A" to S.P. 852, L.D. 2110, BilL "An 
Act 
To 
Establish 
the 
Hospital 
and 
Health 
Care 
Provider 
Cooperation Act" 
Amend the bill in section 1 in §1843 in subsection 3 in the 
2nd line (page 2, line 8 in L.D.) by striking out the following: 
"lLhysician," and inserting in its place the following: "licensed 
community mental health services provider. a physician' 
Further amend the bill in section I in §1843 in subsection 3 
in the 3rd line (page 2, line 9 in L.D.) by striking out the 
following: 
"State ang" and inserting in its place the following: 
'State or' 
Further amend the bill in section 1 in §1844 in subsection 4 
by striking out all of paragraph D (page 4, lines 13 to 15 in 
L.D.) and inserting in its place the following: 
'D. 
This paragraph applies with regard to a public hearing. 
(1) 
The department may hold a public hearing when it 
getermines a public hearing is appropriate. 
(2) The department shall hold a public hearing if 5 or 
more persons who are residents of the State and who are 
from 
the health service area 
to 
be 
served 
by 
the 
applicant reguest. in writing, that a hearing be held. 
Page l-LR3274(2) 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to S.P. 852, L.D .. 2110 
A reguest under this subparagraph must be received by 
the department no later than 30 days after publication 
of the notice under subsection 3. 
(3) 
If a 
public hearing is held, 
an electronic or 
stenographic record of the public hearing must be kept 
as 
part of 
the 
record of 
the 
application 
by 
the 
department. ' 
Further amend the bill in section I in §1844 in subsection 5 
in the 7th line (page 5, line I in L.D.) by inserting after the 
fOllowing: "agreement." the following: 
'The department may not 
issue to health care providers a certificate of public advantage 
for a cooperative agreement that allows coordinated negotiation 
and contracting with payors or employers unless such negotiation 
~nd 
contracting 
are 
ancillary 
to 
clinical 
or 
financial 
integration. ' 
Further amend the bill in section 1 in §1844 in subsection 5 
in paragraph A in the 3rd line (page 5, line 
in L.D.) by 
striking out the following: "benefits may" and inserting in its 
place the following: 
'benefits are likely to' 
in subsection 5 
line (page 5, 
"use of" and 
Further amend the bill in section 1 in §1844' 
in paragraph A in subparagraph (4) in the first 
line 22 in L.D.) by striking out the following: 
inserting in its place the fOllowing: 
'utilization of' 
Further amend the bill in section 1 in §1848 in subsection 4 
in the 2nd line (page 11, line 24 in L.D.) by striking out the 
following: "applicant" and inserting in its place the following: 
'applicants' 
Further amend the bill in section 1 in §1848 in subsection 4 
in the 3rd line (page 11, line 25 in L.D.) by striking out the 
fOllowing: 
"bears" and inserting in its place the following: 
'bear' 
Further 
amend the bill in section 1 
in §1851 in first 
paragraph by deleting the 3rd sentence (page 15, lines 19 to 21 
in 
L.D.) 
and 
inserting 
in its 
place 
the 
following: 
'The 
application fee is $2500 for a certificate of public advantage 
filed by health care providers or hospitals that are not subject 
to the $10,000 fee pursuant to this section.' 
Further amend the bill by striking out all of section 3 and 
inserting in its place the following: 
COMMITTEE AMENDMENT 
~,el '&' 
COMMITTEE AMENDMENT "A" to S.P. 852, L.D. 2110 
'Sec. 3. Report. 
The Department of Health and Human Services 
shall submit 2 reports to the joint standing committee of the 
Legislature having jurisdiction over health and human services 
matters on the experience of the department in administering the 
Hospi tal and Health Care Provider Cooperation Act. 
The reports 
must be submitted by April 1, 2007 and January 1, 2008. 
Sec. 
4. 
Application. 
This 
Act 
applies 
to 
cooperative 
agreements 
entered into 
on or after 
June 
1, 
2006 
that are 
submitted to the Department of Health and Human Services for 
review under the Hospital and Health Care Provider Cooperation 
Act. ' 
SUMMARY 
This amendment is the majority report of the committee. 
This amendment does the following. 
1. 
It 
adds 
licensed 
community 
mental 
health 
services 
providers to the definition of health care providers included in 
the Hospital and Health Care Provider Cooperation Act. 
Mental 
heal th providers are covered by the Hospital Cooperation Act of 
1992 and were inadvertently omitted from the bill. 
2. 
It makes grammatical changes in several places. 
3. 
It prohibits 
issuing 
to 
health 
care 
providers 
a 
certificate of public advantage for a cooperative agreement that 
allows coordinated negotiation and contracting with payors or 
employers unless the negotiation and contracting are ancillary to 
clinical or 
financial 
integration. 
This 
prohibition is 
not 
intended 
to 
preclude 
consideration 
of 
whether 
clinical 
or 
financial integration is necessary to demonstrate that likely 
benefits outweigh likely disadvantages for the issuance of 
a 
certificate of public advantage with respect to a 
cooperative 
agreement for coordinated negotiation and contracting filed by 
hospitals. 
4. 
It requires a public hearing on the application for a 
certificate of public advantage if 5 or more persons request a 
hear ing and requires a record of the hearing to be kept as part 
of the public record of the application. 
5. 
It adds a requirement that the Department of Health and 
Human Services report by April 1, 2007 and January 1, 2008 to the 
joint standing committee of Legislature having jurisdiction over 
health and 
human 
services matters 
on the experience of 
the 
department in administering the Hospital and Health Care Provider 
Cooperation Act. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT '4 " to S.P. 852, L.D. 2110 
6. 
It deletes the delayed effective date and inserts an 
application clause to apply the new law to agreements entered 
into on or after June 1, 2006. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 04128/06 frae 
LD 2110 
LR 3274(02) 
An Act To Establish the Hospital and Health Care Provider Cooperation Act 
Fiscal Note for Bill as Amended by Committee Amendment 'A" 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor revenue increase - General Fund 
Minor cost increase - Other Special Revenue Funds 
Minor revenue increase - Other Special Revenue Funds 
Correctional and Judicial Impact Statements 
This bill may increase the number of civil suits filed in the court system. 
The collection of additional filing fees may increase General Fund revenue by minor amounts. 
Fiscal Detail and Notes 
Costs associated with the enforcement responsibilities can be absorbed by the Department of the Attorney General 
utilizing existing budgeted resources. This legislation may result in a minor increase in dedicated revenue from the 
additional collection of application fees in an amount that can not be determined at this time. Any additional costs to 
the Department of Health and Human Services are expected to be minor and can be absorbed utilizing existing 
budgeted resources, including revenue that will continue to be available as a result of this bill. 
LR3274(2) - Fiscal Note - Page 1 of 1