LD 1611
pg. 21
Page 20 of 73 PUBLIC Law Chapter 469 Page 22 of 73
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LR 2137
Item 1

 
Dirigo Health Insurance must take effect the day following
termination of that enrollee's prior coverage.

 
6.__Quality improvement, disease management and cost
containment.__Dirigo Health shall promote quality improvement,
disease prevention, disease management and cost-containment
programs as part of its administration of Dirigo Health
Insurance.

 
§6911.__Coordination with MaineCare

 
The Department of Human Services is the state agency
responsible for the financing and administration of MaineCare. It
shall pay for MaineCare benefits for MaineCare-eligible
individuals, including those enrolled in health plans in
MaineCare that are providing coverage under Dirigo Health
Insurance.

 
§6912.__Subsidies

 
Dirigo Health may establish sliding-scale subsidies for the
purchase of Dirigo Health Insurance paid by individuals or
employees whose income is under 300% of the federal poverty level
and who are not eligible for MaineCare.__Dirigo Health may also
establish sliding-scale subsidies for the purchase of employer-
sponsored health coverage paid by employees of businesses with
more than 50 employees, whose income is under 300% of the federal
poverty level and who are not eligible for MaineCare.

 
1.__Administration.__Dirigo Health shall, by rule, establish
procedures to administer this section.

 
2.__Individuals eligible for subsidy.__Individuals eligible
for a subsidy must:

 
A.__Have an income under 300% of the federal poverty level,
be a resident of the State, be ineligible for MaineCare
coverage and be enrolled in Dirigo Health Insurance; or

 
B.__Be enrolled in a health plan of an employer with more
than 50 employees.__The health plan must meet any criteria
established by Dirigo Health.__The individual must meet
other eligibility criteria established by Dirigo Health.

 
3.__Limitation of subsidies.__Dirigo Health shall limit the
availability of subsidies to reflect limitations of available
funds.

 
4.__Limitation on amount subsidized.__Dirigo Health may limit
the amount subsidized of the payment made by individual


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