(4)__Conducting public hearings and meetings; and

(5)__Reviewing consumer education materials developed by the forum;

D.__Make recommendations regarding quality assurance and quality improvement priorities for inclusion in the State Health Plan described in Title 2, chapter 5; and

E.__Serve as a liaison between the forum and other organizations working in the field of health care quality.

SUBCHAPTER 3

DIRIGO HEALTH HIGH-RISK POOL

§6971.__Dirigo Health High-risk Pool

Dirigo Health shall establish the Dirigo Health High-risk Pool, referred to in this section as "the high-risk pool" for plan enrollees in accordance with this section.

1.__Eligible enrollees for high-risk pool.__A plan enrollee must be included in the high-risk pool if:

(1)A.__The total cost of health care services for the enro(2)llee exceeds $100,000 in any 12-month period; or

B.__The enrollee has been diagnosed with one or more of the following conditions: acquired immune deficiency syndrome (HIV/AIDS), angina pectoris, cirrhosis of the liver, coronary occlusion, cystic fibrosis, Friedreich's ataxia, hemophilia, Hodgkin's disease, Huntington's chorea, juvenile diabetes, leukemia, metastatic cancer, motor or sensory aphasia, multiple sclerosis, muscular dystrophy, myasthenia gravis, myotonia, heart disease requiring open-heart surgery, Parkinson's disease, polycystic kidney disease, psychotic disorders, quadriplegia, stroke, syringomyelia, and Wilson's disease.

2.__Disease management.__Dirigo Health shall develop appropriate disease management protocols, develop procedures for implementing those protocols and determine the manner in which disease management must be provided to plan enrollees in the high-risk pool. Dirigo Health may include disease management in its contract with participating carriers for Dirigo Health Insurance pursuant to section 6910, contract separately with