An Act To Protect Consumers from Rising Health Care Costs
Maine Legislature, Session 123, LD 1849
Committee: Health and Human Services
Sponsors: BARTLETT, BRAUTIGAM, BRANNIGAN, BROMLEY, BRYANT, COURTNEY, EDMONDS, MARTIN, MILLS, NUTTING, ROTUNDO, SCHNEIDER, STRIMLING, SULLIVAN, BARSTOW, BERRY, BLISS, BOLAND, BURNS, CONOVER, CROCKETT, CUMMINGS, DRISCOLL, EBERLE, FISCHER, HINCK, JACKSON, MAKAS, MOORE, PATRICK, PERRY, PRIEST, SIROIS, TREAT, WALCOTT

Legislative Document 
No. 1849 
S.P.664 
April 10, 2007 
An Act To Protect Consumers from Rising Health Care Costs 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Senator BARTLETT of Cumberland. 
Cosponsored by Representative BRAUTIGAM of Falmouth and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senators: BRANNIGAN of Cumberland, BROMLEY of Cumberland, BRYANT of Oxford, 
COURTNEY of York, President EDMONDS of Cumberland, MARTIN of Aroostook, MILLS 
of Somerset, NUTTING of Androscoggin, ROTUNDO of Androscoggin, SCHNEIDER of 
Penobscot, STRIMLING of Cumberland, SULLIVAN of York, Representatives: BARSTOW 
of Gorham, BERRY of Bowdoinham, BLISS of South Portland, BOLAND of Sanford, 
BRYANT of Windham, BURNS of Berwick, CONOVER of Oakland, CROCKETT of 
Augusta, Speaker CUMMINGS of Portland, DRISCOLL of Westbrook, EBERLE of South 
Portland, FISCHER of Presque Isle, HINCK of Portland, JACKSON of Allagash, MAKAS of 
Lewiston, MOORE of Standish, PATRICK of Rumford, PERRY of Calais, PRIEST of 
Brunswick, SIROIS of Turner, TREAT of Farmingdale, WALCOTT of Lewiston, \\-'EDDELL 
of Frankfort. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A-I. 22 MRSA Subtitle 7 is enacted to read: 
SUBTITLE 7 
REGULATION 
CHAPTER 1701 
MAINE HOSPITAL COST COMMISSION 
SUBCHAPTER 1 
GENERAL PROVISIONS 
§J400i. Findings and declaration of purpose 
1. Findings. The Legislature makes the following findings. 
A. The cost of hospital care in Maine has been increasing much more rapidly than 
the ability of its citizens to support these increases. This disparity is detrimental to 
the public interest. It diminishes the accessibility of hospital services to the people of 
the State and materially compromises their ability to address other equally 
compelling needs. 
B. The current system of financing hospital care is seriously deficient, has directly 
contributed to the rapid rise in costs and is in need of reform in that: 
(1) The current system of financing hospital care fails to ensure that hospitals 
will charge those they serve no more than is needed to meet their reasonable 
financial requirement~; 
(?! The current system of financing hospital care fails to ensure or reward 
efficiency and restraint in hospital spending; 
(3) The current system of financing hospital care is inequitable in that it permits 
hospitals to respond to the legitimate cost containment efforts of the Federal 
Government and the State by increasing their charges to other patients; and 
(4) The current system of financing hospital care threatens the ability of some 
Maine hospitals to generate sufficient revenues to meet their reasonable financial 
requirements and, consequently, will inevitably have an adverse impact on the 
accessibility and the quality of the care available to those whom they serve. 
Page I - 123LR1867(Ol)-1 
C. 
The informed development of public policy regarding hospital and other 
necessary health services requires that the State regularly assemble and analyze 
information pertaining to the use and cost of these services. 
2~ Purposes. The purposes of this chapter are as follows. 
A. It is the intent of the Legislature to protect the public health and promote the 
public interest by establishing a hospital financing system that: 
(1) Appropriately limits the rate of increase in the cost of hospital care from year 
to year; 
(2) Protects the quality and the accessibility of the hospital care available to the 
people of the State by ensuring the financial viability of an efficient and effective 
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state hospital system; 
(3) 
Affords those who pay hospitals a greater role in determining their 
reasonable financial requirements without unduly compromising the ability of 
those who govern and manage hospitals to decide how the resources made 
available to them are to be used; 
( 4) Encourages hospitals to make the most efficient use of the resources made 
available to them in the provision of quality care to those whom they serve and 
the training and continuing education of physicians and other health 
professionals; 
(5) 
Provides predictability in payment amounts for payors, providers and 
patients; and 
(6) Ensures greater equity among purchasers, classes of purchasers and payors. 
§14002. Maine Hospital Cost Commission 
1. Establishment. The Maine Hospital Cost Commission, referred to in this section 
as "the commission," is established as an independent executive agency. 
2. 
Members. 
The commission is composed of 5 members appointed by the 
Governor and subject to review by the joint standing committee of the Legislature having 
jurisdiction over health and human services matters and confirmation by the Legislature. 
3. Appointments. Except as provided in this section, a member may not be: 
A. A representative or employee of an insurance carrier authorized to do business in 
this State; 
B. A representative or employee of a health care provider operating in this State; or 
C. 
Affiliated with a health or health-related organization regulated by State 
Government. 
A nonpracticing health care practitioner, retired or former health care administrator or 
retired or former employee of a health insurance carrier is not prohibited from being 
considered for board membership as long as that person is not affiliated with a health or 
health-related organization at the time of consideration. 
Soo. A-2. Effective date. This Part takes effect September 1, 2008. 
PARTB 
Sec. B-1. Blue Ribbon Commission To Study the Regulation of Health 
Care Expenditures established. 
The Blue Ribbon Commission To Study the 
Regulation of Health Care Expenditures, referred to in this Part as "the commission," is 
established. 
Sec. B-2. Commission membership. The commission consists of 13 members 
appointed as follows: 
1. Three members of the Senate, appointed by the President of the Senate; 
2. Three members of the House of Representatives, appointed by the Speaker of the 
House; 
3. One representative of the business community, appointed by the President of the 
Senate; 
4. Two representatives of hospitals, one appointed by the Speaker of the House and 
one appointed by the President of the Senate; 
5. One representative of commercial health insurers, appointed by the President of the 
Senate; 
6. One representative of labor, appointed by the Speaker of the House; 
7. One representative of consumers, appointed by the Speaker of the House; and 
8. The Director ofthe Governor's Office of Health Policy and Finance. 
Sec. B-3. Chairs. The first-named Senate member is the Senate chair of the 
commission and the first-named House of Representatives member is the House chair of 
the commission. 
Sec. B-4. Appointments; convening of commission. All appointments must 
be made no later than 30 days following the effective date of this Part. The appointing 
authorities shall notify the Executive Director of the Legislative Council once all 
appointments have been completed. Within 15 days after appointment of all members, 
the chairs shall call and convene the first meeting of the commission. 
Sec. B-S. Duties. The commission shall undertake a study of the health care 
system and health care regulation and shall recommend the most appropriate form of 
health care regulation necessary to ensure the provision of quality care, the accessibility 
of care and the affordability of care. The study must include, but is not limited to, an 
evaluation of the current and anticipated market for health care services including 
hospital services, market failures, the current methods and impending trends in the cost, 
financing and delivery of health care including hospital care, the current and anticipated 
environment for health care delivery systems and various methods of regulating health 
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care and health care expenditures to improve the quality of care, stabilize rates charged to 
payors and reduce the rate of increase in costs, including, but not limited to, the 
regulatory system that existed under the former Maine Health Care Finance Commission. 
As part of its recommendations, the commission shaH develop proposed legislation 
detailing the hospital regulation system to be implemented by the Maine Hospital Cost 
Commission pursuant to the Maine Revised Statutes, Title 22, chapter 1701. 
Sec. B-6. Staff assistance. 
The Legislative Council shaH provide necessary 
staffing services to the commission. 
Sec. B-7. Compensation. The legislative members of the commission are entitled 
to receive the legislative per diem, as defined in the Maine Revised Statutes, Title 3, 
section 2, and reimbursement for travel and other necessary expenses related to their 
attendance at authorized meetings of the commission. Public members not otherwise 
compensated by their employers or other entities that they represent are entitled to receive 
reimbursement of necessary expenses and, upon a demonstration of financial hardship, a 
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per diem equal to the legislative per diem for their attendance at authorized meetings of 
the commission. 
Sec. B-8. Report. No later than November 1,2007, the commission shaH submit a 
report that includes its findings and recommendations, including suggested legislation, for 
presentation to the Joint Standing Committee on Health and Human Services and the 
Legislative Council. 
The commission is not authorized to introduce legislation. 
Following receipt and review of the report, the Joint Standing Committee on Health and 
Human Services may submit legislation to the Second Regular Session of the 123rd 
Legislature. 
Sec. B-9. Extension. If the commission requires a limited extension of time to 
complete its study and make its report, it may apply to the Legislative Council, which 
may grant an extension. 
Sec. B-I0. Commission budget. The chairs of the commission, with assistance 
from the commission staff, shaH administer the commission's budget. Within 10 days 
after its first meeting, the commission shall present a work plan and proposed budget to 
the Legislative Council for its approval. The commission may not incur expenses that 
would result in the commission's exceeding its approved budget. Upon request from the 
commission, the Executive Director of the Legislative Council shall promptly provide the 
commission chairs and staff with a status report on the commission budget, expenditures 
incurred and paid and available funds. 
SUMMARY 
Part A of this bill establishes, effective September 1, 2008, the Maine Hospital Cost 
Commission, whose purpose is to appropriately limit the rate increase in the cost of 
hospital care while protecting the quality and accessibility of care available to the people 
of the State and without unduly compromising the ability of hospitals to decide how the 
resources made available to them are to be used. 
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Part B of this bill establishes the Blue Ribbon Commission To Study the Regulation 
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of Health Care Expenditures and directs the commission to undertake a full scale study of 
the health care system and recommend the most appropriate form of health care 
regulation necessary to ensure the provision of quality care, the accessibility to care and 
the affordability of care. As part of its recommendations, the commission is directed to 
develop proposed legislation detailing the hospital regulation system to be implemented 
by the Maine Hospital Cost Commission pursuant to the Maine Revised Statutes, Title 
22, chapter 1701. The commission is directed to submit a report that includes its findings 
and recommendations, including suggested legislation, for presentation to the Joint 
Standing Committee on Health and Human Services no later than November 1, 2007. 
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Following receipt and review of the report, the Joint Standing Committee on Health and 
Human Services may submit legislation to the Second Regular Session of the 123rd 
Legislature.