| | | Be it enacted by the People of the State of Maine as follows: |
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| | | Sec. 1. 24-A MRSA c. 33-A is enacted to read: |
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| | | As used in this chapter, unless the context otherwise | | indicates, the following terms have the following meanings. |
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| | | 1.__Basic care medical plan. "Basic care medical plan" or | | "plan" means a plan providing health care benefits in accordance | | with this chapter. |
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| | | 2. Basic care medical plan pool. "Basic care medical plan | | pool" or "pool" means a pool for distributing the risk among | | carriers as provided in section 2767. |
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| | | 3. Carrier. "Carrier" has the same meaning as in section 4301- | | A, subsection 3. |
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| | | 4. Eligible enrollee. "Eligible enrollee" means a person who, | | at the time of application and determination of eligibility for a | | basic care medical plan, has an annual income at 200% or below | | the federal non-farm income poverty level and has no other health | | insurance or health care coverage. |
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| | | §2762.__Basic care medical plan benefits |
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| | | Carriers may issue basic care medical plans in accordance with | | this chapter, and those plans must meet the following | | requirements. |
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| | | 1. Availability of coverage. Coverage must be available to all | | eligible enrollees beginning on or after January 1, 2006. |
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| | | 2. Mandatory managed care provisions.__The plan must include | | the following managed care provisions to control costs: |
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| | | A. An exclusion for services that are not medically | | necessary or are not covered preventive health services; and |
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| | | B. A procedure for preauthorization by the carrier or its | | designated utilization review entity. |
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