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aggregate measurable cost savings, as determined by the board | pursuant to subsection 1; and |
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| D. The savings offset amount calculation is limited to the | amount of funds necessary to provide subsidies pursuant to | section 6912 and to support the Maine Quality Forum | established in section 6951 and may not include general | administrative expenses of Dirigo Health, except for general | administrative expenses of the Maine Quality Forum. |
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| The savings offset amount determined by the board in accordance | with this subsection is the determining factor for inclusion of | savings offset payments in premiums through rate setting review | by the bureau. |
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| | Sec. 5. 24-A MRSA §6913, sub-§9, as enacted by PL 2003, c. 469, Pt. A, | §8, is amended to read: |
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| | 9. Demonstration of recovery of savings offset payments. As | provided in sections 2736-C, 2808-B and 2839-B, the claims | experience used to determine any filed premiums or rating formula | may not reflect the savings offset payment amount determined in | accordance with subsection 2, but must reasonably reflect, in | accordance with accepted actuarial standards, known changes and | offsets in recovery of savings offset payments by the carrier to | health care providers in this State, including any reduction or | avoidance of bad debt and charity care costs to health care | providers in this State as a result of the operation of Dirigo | Health and any increased enrollment due to an expansion in | MaineCare eligibility occurring after June 30, 2004 as determined | by the board consistent with subsection 1. |
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| | Emergency clause. In view of the emergency cited in the preamble, | this Act takes effect when approved. |
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| | This bill prohibits insurance carriers from including the | costs of the savings offset payment used to support the Dirigo | Health Program in health insurance premium rates. |
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