Sec. F-1. Voluntary limits to control growth of insurance and health care costs; report.
1. Voluntary restraint. In order to control the rate of growth of costs of health care and health coverage, the Legislature asks the cooperation of health care practitioners, hospitals and health insurance carriers.
A. Each health care practitioner, as defined in the Maine Revised Statutes, Title 24, section 2502, subsection 1-A, is asked to limit the growth of net revenue of the practitioner's practice to 3% for the practitioner's fiscal year beginning July 1, 2003 and ending June 30, 2004.
B. Each hospital licensed under Title 22, chapter 405 is asked to voluntarily restrain cost increases, measured as expenses per case mix adjusted discharge, to no more than 3.5% for the hospital fiscal year beginning July 1, 2003 and ending June 30, 2004. Each hospital is asked to voluntarily hold hospital consolidated operating margins to no more than 3% for the hospital's fiscal year beginning July 1, 2003 and ending June 30, 2004.
C. Each health insurance carrier licensed in this State is asked to voluntarily limit the pricing of products it sells in this State to the level that supports no more than 3% underwriting gain less federal taxes for the carrier's fiscal year beginning July 1, 2003 and ending June 30, 2004.
2. Report. By January 1, 2004, the Maine Hospital Association and the Governor's Office of Health Policy and Finance shall agree on a timetable, format and methodology for the hospital association to report on hospital charges, cost efficiency and consolidated operating margins. In accordance with the agreement, the Maine Hospital Association shall report to the Governor and the joint standing committee having jurisdiction over health and human services matters.
Sec. F-2. MaineCare report. The Department of Human Services shall conduct a comprehensive review of reimbursement rates in the MaineCare program and shall report the results of that review to the joint standing committee of the Legislature having jurisdiction over health and human services matters by January 15, 2005. The review must provide opportunity for input from health care consumers, providers, practitioners and insurance carriers and must include consideration of the costs of providing health care in different settings, reflecting the recovery offset in bad debt and charity care, and a review of rates paid in other states and by insurance carriers and the Medicare program. The review must also identify options and costs for increasing rates and must propose strategies for achieving stated priorities. The joint standing committee having jurisdiction over health and human services matters may report out legislation on MaineCare provider rates to the First Regular Session of the 122nd Legislature.
Sec. F-3. Commission to Study Maine's Community Hospitals.
1. Commission established. The Commission to Study Maine's Community Hospitals, referred to in this section as "the commission," is established for the following purposes:
A. To study the roles of community hospitals in the 21st century, including services provided, primary care, medical centers, rural hospitals, teaching hospitals, public health, prevention and education services, relationships with other health care providers, physician recruitment, physician training, and continuing care and to evaluate those roles based on the priorities in the State Health Plan;
B. To study the economic impact of hospitals on the state and local economies;
C. To study funding mechanisms and levels, methods of reimbursement, the role of insurance and 3rd-party payors and the effect of unreimbursed care;
D. To study facility and equipment needs, financing options and capital needs;
E. To study opportunities for hospitals to cooperate through:
(1) Adopting common technologies, record sharing systems and quality control techniques;
(2) Purchasing common services, supplies and pharmaceuticals and selecting and servicing equipment;
(3) Recruiting and training staff;
(4) Managing malpractice, workers' compensation, health care and casualty risks; and
(5) Planning, designing and constructing capital improvements;
F. To explore public policy regarding community hospitals, including incentives and barriers to change, access to health care for consumers and the challenges of making transitions to new community roles;
G. To collect and evaluate data regarding statewide hospital expenditures to assess cost efficiencies, cost effectiveness and overall affordability of available health care services while preserving geographic access to care; and
H. To make recommendations regarding public policy initiatives to better define the roles of the community hospitals and to strengthen the hospitals and equip them to serve the residents of the State through the 21st century.
2. Membership. The commission consists of 9 members appointed by the Governor. The membership of the commission must reflect the geographic diversity of the State. The Governor shall appoint the chair from among the membership. Members serve as volunteers and without compensation or reimbursement for expenses. The membership consists of the following persons:
A. Two persons representing community hospitals chosen from a list submitted by a statewide association representing hospitals;
B. One person representing consumers of health care services;
C. Two persons representing physicians chosen from lists submitted by statewide associations representing allopathic and osteopathic physicians;
D. One person representing employers;
E. One person representing insurers or other 3rd-party payors of health care services;
F. One economist familiar with econometric modeling of health care systems and the analysis and forecasting of health care costs; and
G. One person who has expertise in public health issues.
3. Duties. The commission shall consider the challenges of community hospitals and must be guided by the purposes outlined in subsection 1. The commission may:
A. Hold at least 2 public hearings to collect information from individuals, hospitals, health care providers, insurers, 3rd-party payors, government-sponsored health care programs and interested organizations;
B. Consult with experts in the fields of health care and hospitals and public policy; and
C. Examine any other issues to further the purposes of the study.
4. Staff assistance. The Executive Department shall staff the commission through the Governor's Office of Health Policy and Finance with assistance from the State Planning Office and the Department of Human Services. The Attorney General shall provide all necessary cooperation and assistance to the commission. The commission shall work in cooperation with the Maine Hospital Association.
5. Report. The commission shall submit a report and any suggested legislation to the joint standing committee of the Legislature having jurisdiction over health and human services matters and the joint standing committee of the Legislature having jurisdiction over insurance and financial services matters no later than November 1, 2004.
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