Maine Hospital Association,

DIRIGO HEALTH IMPLEMENTATION UPDATE #1

Organization

Administration

Meetings held with Department of Human Services, Department of Administrative and Financial Services, Department of Professional and Financial Regulation and the Superintendent of Insurance to review departmental responsibilities under the new law. Governors Office of Health Policy and Finance will meet regularly with departments and coordinate implementation

Governor's Office of Health Policy and Finance has developed job descriptions and is advertising to fill two health planner positions to staff committees and support the health planning process

Funding

Governors Office of Health Policy and Finance is in negotiations with various foundations to seek external funding to assist in implementation process (e.g. to fund the hiring of expert consultants, data analysis, study of high risk pools etc.)

Nominations

Nomination process has been completed. Pursuant to PL 439, stakeholders listed in the law, along with others, were invited to submit nominations for the Dirigo Health Board of Directors, the Maine Quality Forum Advisory Council, the Advisory Council on Health Systems Development, the Commission to Study Maine's Hospitals and the Veterans' Health Task Force. Over 250 nominations were received for the 53 appointments to be made by the Governor, most of which require legislative Committee approval. The Dirigo Health Board also requires Senate approval. Announcement of nominees will be made soon.

Dirigo Health

With volunteer assistance from a management consultant, the Governor's Office of Health Policy and Finance is developing a draft business plan and a description of the Executive Director's position. These documents will be ready for review, editing and action by the Dirigo Health Board, once appointed.
Met with disease management expert and discussed how Dirigo can manage enrollees with high risk conditions.

Cost Containment/Health Planning

The Governor has established the Public Purchasers Steering Group, by Executive Order issued last week, and solicited nominees from appropriate entities.
The Governor has sent a letter to Maine hospitals reviewing his expectations for the voluntary budget targets.
The Department of Human Services and the Governor's Office of Health Policy and Finance have negotiated with the Muskie School to conduct the statutorily required study of MaineCare reimbursement.

Other

A meeting was held in Portland in late July with national policy experts, including state officials with experience in health reform, to critique PL 439, help lay out a work plan, to identify possible barriers to implementation and strategies to overcome those barriers.
Staff have participated in numerous meetings and media interviews, responding to inquiries arising within Maine and from across the nation regarding the Reform Act.
Adam Thompson left the staff to pursue his long standing interest in art. Adam will be attending the Penland School of Crafts in Ashville, NC
Laurie Halligan joined our staff as administrative assistant. Laurie's challenge will be to keep the Office of Health Policy and Finance organized!

September 13, 2003:	Public Law 2003, chapter 469 takes effect
Between September 13, 2003 and July 1, 2004:	Appointments to Dirigo Health Board must be made by Governor Dirigo Health Board must be reviewed by Insurance and Financial Services Committee and confirmed by Senate Dirigo Board must hire executive director and appoint other necessary staff, Governor's Office of Health Policy and Finance will also provide initial staffing upon request of Board Dirigo Health Board must develop benefit package; eligibility requirements; mechanism for subsidies; and other specifications for Dirigo Health Insurance (Board must report to Legislature within 30 days after benefit package determined and subsidy program established) Dirigo Health must initiate and complete request-for-proposal process for carriers to offer Dirigo Health Insurance product
February 1, 2004:	Dirigo Health Board must submit recommended methodology and implementing legislation relating to savings offset payments of third-party administrators to Insurance and Financial Services Committee
July 1, 2004-October 1, 2004:	Dirigo Health Insurance must begin offering coverage to Individuals and small businesses Expansion of MaineCare, eligibility contingent on operation of Dirigo Health
October 1, 2004-January 1, 2005:	Dirigo Health Board must begin quarterly reports to Governor and Legislature concerning operation and enrollment in Dirigo Health
April 2006:	Dirigo Health Board must determine aggregate measurable cost savings in bad debt and charity care costs as a result of the operation of Dirigo Health and expansion of MaineCare as basis for savings offset payments
July 1, 2005:	Dirigo Health Board may establish and begin to collect savings offset payments (maximum of 4% of annual premium revenue or its equivalent) from health insurance carriers, employee benefit excess insurance carriers and third-party administrators
January 1, 2006:	Dirigo Health Board must report on disease management protocols, procedures and mechanisms used to provide services to those enrolled in Dirigo's high-risk pool
January 1, 2008:	Dirigo Health Board must submit legislation proposing statewide high-risk pool if Dirigo Health underperforms high-risk pools in other states with regard to trends in average premium rates and average rates of uninsured individuals
By July 1, 2009:	All of Maine's uninsured residents expected to have health coverage through Dirigo Health or other sources of health coverage

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