7.__Organized delivery system requirements.__For fiscal year 2006-07, organized delivery systems must have target loss ratios of 88% and caps on administrative costs of 10%.__For fiscal year 2007-08, organized delivery systems must have target loss ratios of 90% and caps on administrative costs of 8%.__For each succeeding fiscal year, the loss ratio must increase 1% and the administrative cost cap must decrease 1% until the agency determines that the greatest efficiency has been reached.

8.__Role of other health care programs.__Until the agency determines otherwise, the plan is supplemental to all coverage available to a plan member from another health care program, including, but not limited to, the Medicare program of the federal Social Security Act, Title XVIII; the Medicaid program of the federal Social Security Act, Title XIX; the Civilian Health and Medical Program of the Uniformed Services, 10 United States Code, Sections 1071 to 1106; the federal Indian Health Care Improvement Act, 25 United States Code, Sections 1601 to 1682; the statewide plan provided through Dirigo Health Insurance pursuant to Title 24-A, chapter 87; other 3rd-party payors who may be billable for health care services; and any state and local health care programs, including, but not limited to, workers' compensation and employers' liability insurance, pursuant to former Title 39 and Title 39-A.__Health care services billed to 3rd-party payors other than the plan must be paid for by those programs, and coverage under the plan is supplemental to that coverage.__A plan member who receives health care services under another health care program or from a 3rd-party payor to which the plan is supplemental shall pay a premium to the fund in proportion to the health care benefits available to the plan member under the plan.

SUBCHAPTER 3

ENSURING THE QUALITY, AFFORDABILITY AND

EFFICIENCY OF HEALTH CARE

§373.__Quality; affordability; efficiency; health

planning

The agency shall undertake the following duties to ensure the quality, affordability, efficiency and planning of health care for the citizens of the State.