An Act To Protect Consumers and Small Business Owners from Rising Health Care Costs
Maine Legislature, Session 124, LD 1444
Committee Amendment CA_A_S219 (Senate)
Amends: 22 MRSA §8712, 24-A MRSA §6951, 24-A MRSA §2694-A, 22 MRSA §1819-A

COMMITTEE AMENDMENT" II " to S.P. 529, L.D. 1444, Bill, "An Act To 
Protect Consumers and Small Business Owners from Rising Health Care Costs" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'PART A 
Sec. A-I. 22 MRSA §8712, sub-§2, as repealed and replaced by PL 2009, c. 71, 
§ 8, is amended to read: 
2. Cost and quality. The organization shall create a publicly accessible interactive 
website that presents reports related to health care facility and practitioner payments for 
services rendered to residents of the State. The services presented must include, but not 
be limited to, imaging, preventative health, radiology and surgical services and other 
services that are predominantly elective and may be provided to a large number of 
patients who do not have health insurance or are underinsured. The website must also be 
constructed to display prices paid by individual commercial health insurance companies, 
3rd-party administrators and, unless prohibited by federal law, governmental payors. 
A. The organization shall promote public transparency of the quality and cost of 
health care in the State, in conjunction with the Maine Quality Forum as established 
in Title 24-A, section 6951, and shall collect, synthesize and publish information and 
reports on an annual basis that are easily understandable by the average consumer and 
in a format that allows the user to compare the information listed in this section to the 
extent practicable. The organization's publicly accessible websites and reports shall, 
to the extent practicable, coordinate, link and compare information regarding health 
care services, their outcomes, the effectiveness of those services, the quality of those 
services by health care facility and by individual practitioner and the location of those 
services. The organization's health care costs website must provide a link in a 
publicly accessible format to provider-specific information regarding quality of 
services required to be reported to the Maine Quality Forum. 
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COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A 
"to S.P. 529, L.D. 1444 
Sec. A-2. 24-A MRSA §6951, sub-§4, as enacted by PL 2003, c. 469, Pt. A, §8, 
is amended to read: 
4. Reporting. The forum shall work collaboratively with the Maine Health Data 
Organization, health care providers, health insurance carriers and others to report in 
useable formats comparative health care quality information to consumers, purchasers, 
providers, insurers and policy makers. The forum shall produce annual quality reports in 
conjunction with the Maine Health Data Organization pursuant to Title 22, section 8712. 
No later than September 1, 2010, the forum shall make provider-specific information 
regarding quality of services available on its publicly accessible website. 
Sec. A-3. Advisory Council on Health Systems Development; payment 
reform. The Advisory Council on Health Systems Development shall solicit input and 
develop recommendations on payment reform. The council shall: 
1. Solicit input from various stakeholders, including private purchasers of health 
care, working on the measurement and reporting of health care value; 
2. Consult with state agencies with expertise in provider reimbursement and 
payment systems; 
3. Integrate any reforms adopted by the United States Congress or federal agencies 
that affect provider reimbursement; 
4. Review and consider payment reform proposals in other states; and 
5. To the extent permitted by federal and state law, recommend unified payment 
systems across public and private sectors. 
The council shall 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 Joint Standing Committee on Insurance and 
Financial Services no later than January 15,2010. After receipt and review of the report, 
the Joint Standing Committee on Health and Human Services or the Joint Standing 
Committee on Insurance and Financial Services may introduce a bill related to the subject 
matter of the report to the Second Regular Session of the 124th Legislature. 
PARTB 
Sec. B-l. 24-A MRSA §2694-A is enacted to read: 
§2694-A. Physician performance measurement, reporting and tiering programs 
1. 
Performance measurement, reporting and tiering programs. An insurer ' 
delivering or issuing for delivery within the State any individual health insurance policy 
or group health insurance policy or certificate shall annually file with the superintendent 
on or before October 1, 2010 and annually by October 1st in subsequent years a full and 
true statement of its criteria, standards, practices, procedures and programs that measure 
physician performance or tier physician performance. The statement must be on a form 
prepared by the superintendent and may be supplemented by additional information 
required by the superintendent. The statement must be verified by the oath of the insurer's 
president or vice-president, and secretary or chief medical officer. A filing and supporting 
COMMIT 
rE AMENDMENT 
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COMMITTEE AMENDMENT" A" to S.P. 529, L.D. 1444 
infonnation are public records notwithstanding Title 1, section 402, subsection 3, 
paragraph B. 
2. Duties. The superintendent shall review the statements, if any, assemble the 
statements in one table using a side-by-side comparison format and provide an analysis 
identifying the commonalities and differences of the statements. Notwithstanding any 
provision of law to the contrary, the superintendent shall adopt by rule a program and 
perfonnance measures designed to: 
A. Ensure transparency and fairness and promote the continued strengthening of 
measurement programs to meet patients' needs; 
B. 
Promote the consistency, efficiency and fairness of physician perfonnance 
measurement; and 
C. Promote an appropriate balance between innovation and standardization. 
3. Advisory panel. The superintendent may consult with the Advisory Council on 
Health Systems Development for advice to the superintendent regarding the proposed 
rule. 
4. Rulemaldng. The superintendent may adopt rules to implement this section. Rules 
adopted pursuant to this subsection are major substantive rules as defined in Title 5, 
chapter 375, subchapter 2-A. 
PART C 
Sec. e-l. 22 MRSA §1819-A, 2nd ~, as enacted by PL 2005, c. 249, §1, is 
amended to read: 
Infonnation required to be disclosed under this section must be submitted by the 
hospital to the department within 5 months after the end of the hospital's fiscal year or 
within 5 months after the date on which the entity files the applicable fonn with the 
Internal Revenue Service. The department shall make available for public inspection and 
photocopying copies of all documents required by this section and shall post those 
documents on the department's publicly accessible website. The department shall post a 
chart on the website listing each hospital and providing a link to the documents filed 
pursuant to subsection 1. 
Sec. C-2. Posting of documents. Within 30 days of the effective date of this Act, 
the Department of Health and Human Services shall post the federal Internal Revenue 
Service Fonn 990 and all related disclosable schedules for each hospital licensed in the 
State and filed with the department as required in the Maine Revised Statutes, Title 22, 
section 1819-A.' 
SU~Y 
This amendment is the majority report of the committee and replaces the bill. 
Part A directs the Advisory Council on Health Systems Development to develop 
recommendations on payment refonn. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" A" to S.p. 529, L.D. 1444 
Part B directs the Superintendent of Insurance to adopt rules for physician 
performance measurement, reporting and tiering programs. 
The superintendant may 
consult with the advisory council. 
Part C requires that the Department of Health and Human Services post on its 
publicly accessible website the federal Internal Revenue Service Form 990 and forms 
already filed by hospitals with the department within 30 days of the effective date of the 
bill, as amended. 
]FISCAL XOTE HEQURED 
(~ee attached) 
COMMITTEE AMENDMENT 
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Approved: OS/24/09 .?Hac 
LD 1444 
LR 1351(02) 
An Act To Protect Consumers and Small Business Owners from Rising Health Care Costs 
Fiscal Detail and Notes 
Fiscal Note for Bill as Amended by Committee Amendment 'i4" 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Multiple Funds 
Additional costs to affected State agencies and programs can be absorbed utilizing existing budgeted resources. 
LR1351(02) - Fiscal Note - Page 1 of 1