A slew of new laws enacted last week in Maine change the funding mechanism for its universal healthcare program, tighten certificate-of-need rules and boost surveillance reporting on hospital-acquired infections.
Maine revamps funding formula
The state is abandoning its savings offset payment for Dirigo Health, now assessed at a variable rate of up to 4% of paid claims, to instead put in place a fixed 2.14% assessment on paid claims, starting Oct. 1. The variable rate had been a target of lawsuits and was opposed by health insurers. Dirigo Health, established in 2003, covers about 9,300 people.
In separate legislation, Maine expanded its CON rules to apply to new medical equipment costing more than $1.6 million and replacement medical equipment costing more than $2 million. Some members of the Legislature sought to extend CON requirements to hospital-owned and -operated medical office buildings, but that provision was taken out of the final version of the bill.
Under the new law, hospitals also must get CON approval for capital expenditures above $3 million. The legislation provides more state oversight of major medical equipment purchases, said Mary Mayhew, vice president of government affairs for the Maine Hospital Association, who described the final law as a compromise and said that the MHA did not oppose it.
Two other new laws require Maine hospitals to do more to stop the spread of methicillin-resistant Staphylococcus aureus infections, including targeted surveillance of high-risk patients and public reporting of adherence to precautionary measures.
A separate quality law assesses $10,000 fines on Maine hospitals that fail to report serious medical errors to the state, and expands the list of reportable sentinel events to the 28 never events recognized by the National Quality Forum. These errors include wrong-site surgeries, severe pressure ulcers and death or serious injury as the result of a fall.
And health insurers must pay for standard healthcare services provided through telemedicine starting in January 2010 under a separate bill signed into law. Maine Gov. John Baldacci plans to spend $3.5 million in federal recovery dollars toward local medical school student scholarships and $500,000 to pilot a patient-centered primary-care model.
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