An Act to Strengthen the Sustainability and Value of Maine's Designated Health Information Exchange by Acquiring Enhanced Federal Funding
Maine Legislature, Session 131, LD 1676
Committee: Health Coverage, Insurance and Financial Services
Sponsors: PERRY
Amends: 22 MRSA §1711-F

Legislative Document
No. 1676
H.P. 1074
House of Representatives, April 13, 2023
An Act to Strengthen the Sustainability and Value of Maine's 
Designated Health Information Exchange by Acquiring Enhanced 
Federal Funding
Submitted by the Department of Health and Human Services pursuant to Joint Rule 204.
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative PERRY of Calais.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  22 MRSA §1711-F, sub-§1, as enacted by PL 2009, c. 387, §3, is amended 
to read:
1.  Definitions.  For the purposes of this section, "health care facility" has the same 
meaning as in section 1711‑C, subsection 1, paragraph D and, "health care practitioner" 
has the same meaning as in section 1711‑C, subsection 1, paragraph F and "health care 
systems" means 2 or more health care organizations that are affiliated with each other 
through either contractual or shared ownership, with at least one hospital and at least one 
physician organization.
Sec. 2.  22 MRSA §1711-F, sub-§4 is enacted to read:
4.  Use of enhanced federal matching funds.  The state-designated health information 
exchange shall use enhanced federal matching funds for infrastructure and operations and 
to subsidize or offset participants' fees in a manner that is equitable across provider 
participants and is reasonable and sustainable.
Sec. 3.  22 MRSA §1711-F, sub-§5 is enacted to read:
5.  Board of directors governing state-designated health information exchange.  
After approval is obtained for enhanced federal matching funds for the state-designated 
health information exchange, the bylaws of the state-designated health information 
exchange must provide that:
A.  A designee of the commissioner shall participate in the executive finance committee 
of the board of directors governing the state-designated health information exchange;
B.  The board of directors governing the state-designated health information exchange 
includes a designee of the commissioner from the Office of MaineCare Services; and
C.  The board of directors governing the state-designated health information exchange 
includes at least one enrolled MaineCare provider nominated by the commissioner, 
based on the provider's demonstration of the provider's use of the state-designated 
health information exchange to benefit the value of health care services provided to 
MaineCare members.
Sec. 4.  22 MRSA §1711-F, sub-§6 is enacted to read:
6.  Plan; changes to documents.  The state-designated health information exchange 
shall present a plan to the department annually, starting within 2 months after approval is 
obtained for enhanced federal matching funds for the state-designated health information 
exchange, to ensure sustainability of overall state-designated health information exchange 
operations and financial support for any increased investment required for the state share 
of funds.  Annual changes to documents the department submits to the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
in connection with enhanced federal matching funds are contingent on state department 
approval of the annual state-designated health information exchange operational budget.
Sec. 5.  22 MRSA §1711-F, sub-§7 is enacted to read:
7.  MaineCare access to data.  The state-designated health information exchange shall 
provide the department's Office of MaineCare Services with access to member data 
collected through the state-designated health information exchange, including clinical and 
utilization data, consistent with allowable uses of these data in the office's role as an entity 
covered by the federal Health Insurance Portability and Accountability Act of 1996, for the 
administration of the MaineCare program, treatment and coordination of care for its 
members, including the review of real-time health care use among MaineCare members, 
the calculation of performance measures, including but not limited to clinical quality 
measures, identification of statistics and analytics related to the MaineCare population and 
the assessment of quality performance by health care providers for consideration in the 
design and ongoing operations of alternative payment models that tie payment to provider 
performance.  Data access may not be used for the purpose of program integrity or to 
administer administrative sanctions or penalties.  The state-designated health information 
exchange data may not be used to determine medical necessity for medical payment 
purposes.
Sec. 6.  22 MRSA §1711-F, sub-§8 is enacted to read:
8.  MaineCare providers that are hospitals or part of health care system.  A 
provider located in this State and enrolled in MaineCare that is a hospital or part of a health 
care system shall maintain persistent data connection and clinician access to the state-
designated health information exchange in order to ensure that MaineCare members may 
continue to benefit from improved care coordination and care provisions resulting from the 
exchange of clinical data across provider settings and systems.
Sec. 7.  Department of Health and Human Services to apply for approval 
to obtain enhanced federal matching funds for state-designated health 
information exchange; use of funds.  Upon the achievement by the Department of 
Health and Human Services of outcomes-based certification by the United States 
Department of Health and Human Services, Centers for Medicare and Medicaid Services 
for the state-designated statewide health information exchange under the Maine Revised 
Statutes, Title 22, section 1711-F, the state department shall submit an operational advance 
planning document for approval by the centers to obtain enhanced federal matching funds 
to support ongoing infrastructure and operational support for the state-designated health 
information exchange, proportional to the benefit of the state-designated health information 
exchange to MaineCare members and to enrolled MaineCare providers in comparison to 
the benefit for all patients and providers in the state-designated health information 
exchange.
SUMMARY
This bill directs the Department of Health and Human Services to submit an operational 
advance planning document for approval by the United States Department of Health and 
Human Services, Centers for Medicare and Medicaid Services to obtain enhanced federal 
matching funds to support the state-designated health information exchange.  Subsequent 
to approval by the centers of the operational advance planning document and achievement 
of outcomes-based certification, it requires the bylaws of the state-designated health 
information exchange to include greater department representation in the makeup of the 
board of directors governing the state-designated health information exchange and requires 
broad MaineCare access to state-designated health information exchange patient data from 
providers.  It further requires the state-designated health information exchange to submit 
an annual plan to the department to ensure stable state-designated health information 
exchange operations and financial support and requires MaineCare providers that are 
hospitals or part of a health care system to maintain a persistent data connection and 
clinician access to the state-designated health information exchange.