Sec. A-5. Commission to Study the Challenges of Community Nonprofit Hospitals

1. Commission established. The Commission to Study the Challenges of Community Nonprofit Hospitals, referred to in this section as the "commission," is established for the following purposes:

A. To study the roles of community nonprofit hospitals in the 21st century, including their relationships with other health care providers and their communities. The study must include options for new community roles, including dental care and flexibility in the use of hospital beds and facilities;

B. To study funding mechanisms and levels, methods of reimbursement, the role of insurance and 3rd-party payors and the effect of unreimbursed care;

C. To study facility and equipment needs, financing options and capital needs for the future;

D. To explore public policy regarding community nonprofit hospitals and incentives and barriers to change. Public policy questions to be considered must include access to health care for consumers and the challenges of making transitions to new community roles;

E. To make recommendations regarding public policy initiatives to better define the roles of the community nonprofit hospitals and to strengthen the hospitals and equip them to serve the residents of the State through the 21st century; and

F. To study areas in which the hospitals may be able to collaborate with other health care providers, particularly rural and community health clinics, to improve the delivery of health care and reduce duplication of effort among providers.

2. Membership. The commission consists of 13 members, each of whom must possess a strong interest or expertise in community nonprofit hospitals.

A. The President of the Senate shall appoint:

(1) Three members of the Senate, at least one from each of the 2 major political parties; and

(2) One person representing community nonprofit hospitals, one person representing statewide organizations of consumers of health care services and one person representing insurers or other 3rd-party payors of health care services.

B. The Speaker of the House of Representatives shall appoint:

(1) Three members of the House, at least one of whom must represent the minority party; and

(2) One person representing community nonprofit hospitals, one person representing statewide organizations of consumers of health care services and one person representing insurers or other 3rd-party payors of health care services.

C. The Commissioner of Human Services or a representative of the commissioner is a member of the commission.

When making the appointments, the President of the Senate and the Speaker of the House shall give preference to members from the Joint Standing Committee on Health and Human Services.

3. Appointments; chairs; convening of commission. All appointments must be made no later than 30 days following the effective date of this section. The appointing authorities shall notify the Executive Director of the Legislative Council once all appointments have been made. The first named Senate member is the Senate chair and the first named House of Representatives member is the House chair. The first meeting must be called by the chairs no later than September 30, 2001.

4. Duties. The commission shall consider the challenges of community nonprofit hospitals and must be guided by the purposes outlined in subsection 1. The commission may:

A. Hold 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.

5. Staff assistance. Upon approval of the Legislative Council, the Office of Policy and Legal Analysis shall provide necessary staffing services to the commission.

6. Compensation. 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 for attendance at authorized meetings of the commission.

7. Report. The commission shall submit a report and any necessary implementing legislation to the Second Regular Session of the 120th Legislature no later than November 15, 2001. If the commission requires an extension of time to make its report, it may apply to the Legislative Council, which may grant the extension.

8. Commission budget. The chairs of the commission, with assistance from the commission staff, shall administer the commission 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 or the executive director's designee shall provide the commission chairs and staff with a status report on the commission budget, expenditures incurred and paid and available funds.

PART B

Sec. B-1. 22 MRSA §1, first ¶, as amended by PL 1983, c. 409, §1, is further amended to read:

The Department of Health and Human Services, as established and in this Title called the "department" shall consist consists of such bureaus and divisions as may be required to carry out the work of the department. The department shall must have an official department seal, which shall must be judicially noticed.

Sec. B-2. 22 MRSA §1, 2nd ¶, as amended by PL 1993, c. 685, Pt. B, §2, is further amended to read:

The department is under the control and supervision of the Commissioner of Health and Human Services, referred to in this Title as the "commissioner," who is appointed by the Governor,

subject to review by the joint standing committee of the Legislature having jurisdiction over health and human resources services matters and to confirmation by the Legislature, and serves at the pleasure of the Governor.

Sec. B-3. 22 MRSA §1, 3rd ¶, as amended by PL 1995, c. 560, Pt. J, §2, is further amended to read:

The commissioner may employ any bureau and division heads, deputies, assistants and employees who may be necessary to carry out the work of the department. All personnel of the department are under the immediate supervision, direction and control of the commissioner. These personnel are employed subject to the Civil Service Law, except the Deputy Commissioner; Director, Bureau of Child and Family Services; Director, Bureau of Elder and Adult Services; Director, Bureau of Health; Director, Bureau of Family Independence; Director, Bureau of Health and Medical Services; Assistant Deputy Commissioners; and 3 Regional Executive Managers.

Sec. B-4. Interpretation. Until such time as the Legislature enacts legislation to fully implement the change in name of the Department of Human Services to "Department of Health and Human Services," until such time as the department amends its rules and any plans and program information on file with the Federal Government and until such time as the department amends or alters contracts and written obligations of the department, the words "Department of Human Services" as they may appear in the Maine Revised Statutes, in rules, plans and program information and in contracts and written obligations of the department are deemed to mean the Department of Health and Human Services, except for references that clearly refer to the former Department of Human Services.

Sec. B-5. MaineCare program. Effective January 1, 2002, the name of the Medicaid program and the name of the Cub Care program in this State are changed to "MaineCare program." Pending the effective date and final changes to law, rule, plan and contract, the Department of Human Services may use the name "MaineCare program" in reference to the Medicaid program and the Cub Care program.

Sec. B-6. Interpretation. Until such time as the Legislature enacts legislation to fully implement the change in name of the Medicaid program to "MaineCare program" and the change in name of the CubCare program to "MaineCare program," until such time as the department amends its rules and any plans and program information on file with the Federal Government and until such time as the department amends or alters contracts and written obligations of the department, the words "Medicaid" and "Cub Care" as they may appear in the Maine Revised Statutes, in

rules, plans and program information and in contracts and written obligations of the department are deemed to mean the MaineCare program, except for references that clearly refer to the former Medicaid and Cub Care programs.

Sec. B-7. Review and report. The Revisor of Statutes shall review amendments to the Maine Revised Statutes that are required to fully implement the change in name of the Department of Human Services to "Department of Health and Human Services," the change in name of the Medicaid program to "MaineCare program" and the change in name of the Cub Care program to "MaineCare program." By January 10, 2002, the Revisor of Statutes shall report to the Second Regular Session of the 120th Legislature the legislation that is needed to bring the laws into conformity with the new name of the department. The Joint Standing Committee on Health and Human Services may report out a bill to the Second Regular Session of the 120th Legislature to implement the recommendations of the Revisor of Statutes.

PART C

Sec. C-1. 22 MRSA §1718 is enacted to read:

§1718.__Electronic filing of claims

By July 1, 2002, a person, facility or other entity licensed to provide health care services to persons in this State shall develop the ability to file claims for services by electronic means.__By July 1, 2003, each person, facility or entity shall file at least 50% of all health care service claims by electronic means.

Sec. C-2. 24 MRSA §2332-E, as enacted by PL 1993, c. 477, Pt. D, §5 and affected by Pt. F, §1, is amended to read:

§2332-E. Standardized claim forms

On or after December 1, 1993, all All nonprofit hospital or medical service organizations and nonprofit health care plans providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed physician or, chiropractor must or other person, facility or entity licensed to provide health care services to persons in this State shall accept the current standardized claim form approved by the Federal Government Maine Health Data Organization pursuant to Title 22, section 8704, subsection 12 and shall accept claims filed by electronic means. On or after December 1, 1993, all nonprofit hospital or medical service organizations and nonprofit health care plans providing payment or reimbursement for

diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form approved by the Federal Government.

Sec. C-3. 24-A MRSA §2753, as enacted by PL 1993, c. 477, Pt. D, §10 and affected by Pt. F, §1, is amended to read:

§2753. Standardized claim forms

On or after December 1, 1993, insurers providing individual medical expense insurance on an expense-incurred basis Insurers providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed physician or, chiropractor must or other person, facility or entity licensed to provide health care services to persons in this State shall accept the current standardized claim form approved by the Federal Government Maine Health Data Organization pursuant to Title 22, section 8704, subsection 12 and shall accept claims filed by electronic means. On or after December 1, 1993, all insurers providing individual medical expense insurance on an expense-incurred basis providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form approved by the Federal Government.

Sec. C-4. 24-A MRSA §2823-B, as enacted by PL 1993, c. 477, Pt. D, §11 and affected by Pt. F, §1, is amended to read:

§2823-B. Standardized claim forms

On or after December 1, 1993, all All insurers providing group medical expense insurance on an expense-incurred basis providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed physician or, chiropractor must or other person, facility or entity licensed to provide health care services to persons in this State shall accept the current standardized claim form approved by the Federal Government Maine Health Data Organization pursuant to Title 22, section 8704, subsection 12 and shall accept claims filed by electronic means. On or after December 1, 1993, all insurers providing group medical expense insurance on an expense-incurred basis providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form approved by the Federal Government.

Sec. C-5. 24-A MRSA §4235, as enacted by PL 1993, c. 477, Pt. D, §12 and affected by Pt. F, §1, is amended to read:

§4235. Standardized claim forms

On or after December 1, 1993, all All health maintenance organizations providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed physician or, chiropractor must or other person, facility or entity licensed to provide health care services to persons in this State shall accept the current standardized claim form approved by the Federal Government Maine Health Data Organization pursuant to Title 22, section 8704, subsection 12 and shall accept claims filed by electronic means. On or after December 1, 1993, all health maintenance organizations providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form approved by the Federal Government.

Sec. C-6. Technical assistance. From October 1, 2001, to September 1, 2002, all health insurance carriers, nonprofit hospital and medical service organizations and health maintenance organizations licensed to provide health coverage to persons in this State shall provide, without charge, technical assistance regarding the filing of claims by electronic means to persons, facilities and entities licensed to provide health care services in this State. The Department of Professional and Financial Regulation, Bureau of Insurance may adopt rules necessary to implement this section. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter II-A. This section takes effect October 1, 2001.

Sec. C-7. Effective date. Except as otherwise provided, this Part takes effect July 1, 2002, and that section of this Part that enacts Title 22, section 1718 takes effect October 1, 2001.

PART D

Sec. D-1. 32 MRSA §1099-A is enacted to read:

§1099-A.__Dental hygiene in public health setting

Notwithstanding any provision of this chapter, a dental hygienist may practice dental hygiene in a public health setting under the general supervision of a dentist.__The dentist shall provide supervision by review of patient records and consultation in person or by other means of communication.__For the purposes of this section, "public health setting" means a public or private school, hospital, clinic, community or rural health clinic, nursing facility or other institution or health care facility or nontraditional practice setting.__The dentist providing general supervision must have specific standing orders

or policy guidelines for procedures that are to be carried out.__ The__dentist need not be present when the procedures are being performed.__A written plan for referral or an agreement for follow-up must be provided by the dental hygienist, recording all conditions that should be brought to the attention of the dentist.__A summary report once a year must be reviewed by the supervising dentist.

SUMMARY

This bill contains a number of provisions to enhance access to health care and update the laws covering the Department of Human Services and the Maine Health Data Organization. The bill also does the following.

1. It requires the Maine Health Data Organization to make its data available to the Department of Human Services for comprehensive health planning.

2. It requires the Maine Health Data Organization to adopt rules for the use of a uniform billing form to be effective July 1, 2002.

3. It requires any savings realized as a result of using the uniform billing form by the Department of Corrections, the Department of Education, the Department of Human Services and the Department of Mental Health, Mental Retardation and Substance Abuse Services to be deposited in a dedicated fund established to increase access to health care.

4. It establishes the Commission to Study the Challenges of Community Nonprofit Hospitals to study and make recommendations on the roles of community nonprofit hospitals through the 21st century.

5. It changes the name of the Department of Human Services to "Department of Health and Human Services" and changes the name of the Bureau of Medical Services to "Bureau of Health and Medical Services." The bill contains transition language pending full amendment to state laws, federal plans and program information and departmental contracts and written obligations.

6. It changes the names of the Medicaid and Cub Care programs to "MaineCare program" effective January 1, 2002. The bill contains transition language pending full amendment to state

laws, federal plans and program information and departmental contracts and written obligations.

7. It requires providers of health care services to develop the ability to file claims electronically for their services by July 1, 2002 and requires 50% of all claims to be filed electronically by July 1, 2003. It requires insurance carriers, nonprofit hospital and medical service organizations and health maintenance organizations to accept claims filed electronically and requires those entities to provide technical assistance to providers regarding electronic claims filing from October 1, 2001 to September 1, 2002.

8. It allows dental hygienists to practice dental hygiene under the general supervision of a dentist in public health settings. "Public health setting" is defined as a public or private school, hospital, clinic, nursing facility or other institution or health care facility or nontraditional practice setting.