Work Continues on Dirigo Health Plan; MMA Negotiates - Outcome Uncertain
The Legislature's Joint Select Committee on Health Care Reform held work sessions for several hours over three days this past week. Committee members seemed to acknowledge that a number of difficult issues with L.D. 1611 became apparent at the public hearing and that further negotiations would be required between the Governor's Office of Health Policy and Finance and the physician, hospital and insurance communities before the Committee could complete work on the bill.
At the work session on Thursday afternoon, Senate Chairman Michael Brennan reviewed the most contentious items and directed MMA, the Maine Hospital Association, and the Maine Association of Health Plans to meet with the Governor's staff to attempt to negotiate the key issues for each group. These issues include the CON issue for physicians, the global budget issue for hospitals and physicians and the 4.1% premium assessment for insurers.
This list of issues is by no means exhaustive of the issues still being discussed. At a 7:00am meeting tomorrow (Tuesday) morning, MMA representatives will discuss with the Governor's representatives the following items:
l. Expanding medicaid eligibility without increasing reimbursement
2. Global budgets, both overall and in connection with annual CON approvals.
3. Expansion of Certificate of Need to not only Ambulatory Surgical Centers but also to private physician offices, subject to state-imposed monetary thresholds.
4. Mandated disclosure of fees and average amounts received per service or procedure
5. Mandatory electronic billing, regardless of practice size
6. Mandatory reporting of 'quality' data from the physician office to the Maine Health Data Organization, with subsequent publication of the data in order to compare providers on performance measurements developed by the Maine Quality Forum.
7. Lack of physician representation on the Dirigo Health Board and the Maine Quality Forum Advisory Council (one M.D. among 15 representatives.)
While there is much to be admired and commended in the Governor's Plan, such as the attempt to cover more individuals, MMA can not and will not support the proposal unless adequate amendments can be negotiated or otherwise achieved dealing with the above issues.
Work sessions will continue on the bill this week on Tuesday, Wednesday and Thursday afternoons and presumably next week as well. While many Republican legislators are urging for the bill to be held over to the next session, there continues to be strong Democratic support for passing an amended version of the bill this session. The session is scheduled to adjourn in mid-June.
House members may be called by leaving a message at 1-800-423-2900 or 287-1400. Members of the State Senate can be reached by calling 1-800-423-6900 or 287-1540. A call to your legislators to discuss your thoughts on the Governor's plan would be very helpful.