Maine Code § 24-A-6908

Powers and duties of Dirigo Health
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1. Powers. Subject to any limitations contained in this chapter or in any other law, Dirigo Health
may:
A. Take any legal actions necessary or proper to recover or collect payments due Dirigo Health or
that are necessary for the proper administration of Dirigo Health; [PL 2007, c. 629, Pt. M, §12
(AMD).]

B. Make and alter bylaws, not inconsistent with this chapter or with the laws of this State, for the
administration and regulation of the activities of Dirigo Health; [PL 2003, c. 469, Pt. A, §8
(NEW).]
C. Have and exercise all powers necessary or convenient to effect the purposes for which Dirigo
Health is organized or to further the activities in which Dirigo Health may lawfully be engaged,
including the establishment of the Dirigo Health Program; [PL 2005, c. 400, Pt. C, §5 (AMD).]
D. Engage in legislative liaison activities, including gathering information regarding legislation,
analyzing the effect of legislation, communicating with Legislators and attending and giving
testimony at legislative sessions, public hearings or committee hearings; [PL 2003, c. 469, Pt. A,
§8 (NEW).]
E. Take any legal actions necessary to avoid the payment of improper claims against Dirigo Health
or the coverage provided by or through Dirigo Health, to recover any amounts erroneously or
improperly paid by Dirigo Health, to recover any amounts paid by Dirigo Health as a result of
mistake of fact or law and to recover other amounts due Dirigo Health; [PL 2003, c. 469, Pt. A,
§8 (NEW).]
F. Enter into contracts with qualified 3rd parties both private and public for any service necessary
to carry out the purposes of this chapter; [PL 2003, c. 469, Pt. A, §8 (NEW).]
G. Conduct studies and analyses related to the provision of health care, health care costs and
quality; [PL 2003, c. 469, Pt. A, §8 (NEW).]
H. Establish and administer a revolving loan fund to assist health care practitioners and health care
providers in the purchase of hardware and software necessary to implement the requirements for
electronic submission of claims. Dirigo Health may solicit matching contributions to the fund from
each health insurance carrier licensed to do business in this State; [PL 2003, c. 469, Pt. A, §8
(NEW).]
I. Apply for and receive funds, grants or contracts from public and private sources; [PL 2003, c.
469, Pt. A, §8 (NEW).]
J. Contract with the Maine Health Data Organization and other organizations with expertise in
health care data, including a nonprofit health data processing entity in this State, to assist the Maine
Quality Forum established in section 6951 in the performance of its responsibilities; [PL 2003, c.
469, Pt. A, §8 (NEW).]
K. Provide staff support and other assistance to the Maine Quality Forum established in section
6951, including assigning a director and other staff as needed to conduct the work of the Maine
Quality Forum; and [PL 2003, c. 469, Pt. A, §8 (NEW).]
L. In accordance with the limitations and restrictions of this chapter, cause any of its powers or
duties to be carried out by one or more organizations organized, created or operated under the laws
of this State. [PL 2003, c. 469, Pt. A, §8 (NEW).]
[PL 2007, c. 629, Pt. M, §12 (AMD).]
2. Duties. Dirigo Health shall:
A. Establish administrative and accounting procedures as recommended by the State Controller
for the operation of Dirigo Health in accordance with Title 5; [PL 2003, c. 469, Pt. A, §8 (NEW).]
B. Collect the savings offset payments provided in former section 6913 and the access payment
provided in section 6917; [PL 2009, c. 359, §1 (AMD); PL 2009, c. 359, §8 (AFF).]
C. Determine the comprehensive services and benefits to be included in the Dirigo Health Program
and develop the specifications for the Dirigo Health Program in accordance with the provisions in
section 6910. Within 30 days of its determination of the benefit package to be offered through the

Dirigo Health Program, the board shall report on the benefit package, including the estimated
premium and applicable coinsurance, deductibles, copayments and out-of-pocket maximums, to
the joint standing committee of the Legislature having jurisdiction over appropriations and financial
affairs, the joint standing committee of the Legislature having jurisdiction over insurance and
financial services matters and the joint standing committee of the Legislature having jurisdiction
over health and human services matters; [PL 2005, c. 400, Pt. C, §6 (AMD).]
D. Develop and implement a program to publicize the existence of Dirigo Health and the Dirigo
Health Program and the eligibility requirements and the enrollment procedures for the Dirigo
Health Program and to maintain public awareness of Dirigo Health and the Dirigo Health Program;
[PL 2005, c. 400, Pt. C, §6 (AMD).]
E. Arrange the provision of Dirigo Health Program benefit coverage to eligible individuals and
eligible employees through contracts with one or more qualified bidders in accordance with section
6910 or through the Dirigo Health Self-administered Plan authorized pursuant to section 6981; [PL
2007, c. 447, §6 (AMD).]
F. [PL 2007, c. 629, Pt. L, §2 (RP).]
G. Establish and operate the Maine Quality Forum in accordance with the provisions of section
6951 ; and [PL 2007, c. 629, Pt. L, §3 (AMD).]
H. On a quarterly basis no less than 60 days from the end of each quarter, collect and report on:
(1) The total enrollment in the Dirigo Health Program, including the number of enrollees
previously underinsured or uninsured, the number of enrollees previously insured, the number
of individual enrollees and the number of enrollees enrolled through small employers;
(2) The number of new participating employers in the Dirigo Health Program;
(3) The number of employers ceasing to offer coverage through the Dirigo Health Program;
(4) The duration of employers' participation in the Dirigo Health Program; and
(5) A comparison of actual enrollees in the Dirigo Health Program to projected enrollees.
Dirigo Health shall submit the quarterly reports required under this subsection to the
superintendent, to the joint standing committee of the Legislature having jurisdiction over
appropriations and financial affairs, to the joint standing committee of the Legislature having
jurisdiction over insurance and financial services matters and to the joint standing committee of the
Legislature having jurisdiction over health and human services matters. [PL 2007, c. 629, Pt. L,
§4 (NEW).]
[PL 2009, c. 359, §1 (AMD); PL 2009, c. 359, §8 (AFF).]
3. Budget. The revenues and expenditures of Dirigo Health are subject to legislative approval in
the biennial budget process. At the direction of the board, the executive director shall prepare the budget
for the administration and operation of Dirigo Health in accordance with the provisions of law that
apply to departments of State Government.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
4. Audit. Dirigo Health must be audited annually by the State Auditor. The board may, in its
discretion, arrange for an independent audit to be conducted. A copy of the audit must be provided to
the State Controller, to the superintendent, to the joint standing committee of the Legislature having
jurisdiction over appropriations and financial affairs, to the joint standing committee of the Legislature
having jurisdiction over insurance and financial services matters and to the joint standing committee of
the Legislature having jurisdiction over health and human services matters.
[PL 2003, c. 469, Pt. A, §8 (NEW).]

5. Rulemaking. Dirigo Health may adopt rules as necessary for the proper administration and
enforcement of this chapter, pursuant to the Maine Administrative Procedure Act. Unless otherwise
specified, rules adopted pursuant to this chapter are routine technical rules as defined in Title 5, chapter
375, subchapter 2-A.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
6. Annual report. Beginning September 1, 2004, and annually thereafter, the board shall report
on the impact of Dirigo Health on the small group and individual health insurance markets in this State
and any reduction in the number of uninsured individuals in the State. The board shall also report on
membership in Dirigo Health, the administrative expenses of Dirigo Health, the extent of coverage, the
effect on premiums, the number of covered lives, the number of Dirigo Health Program policies issued
or renewed and Dirigo Health Program premiums earned and claims incurred by health insurance
carriers offering coverage under the Dirigo Health Program. The board shall submit the report to the
Governor, the joint standing committee of the Legislature having jurisdiction over appropriations and
financial affairs, the joint standing committee of the Legislature having jurisdiction over health
insurance and financial services matters and the joint standing committee of the Legislature having
jurisdiction over health and human services matters.
[PL 2005, c. 400, Pt. C, §7 (AMD).]
7. Technical assistance from other state agencies. Other state agencies, including, but not
limited to, the bureau, the Department of Health and Human Services, Maine Revenue Services and the
Maine Health Data Organization, shall provide technical assistance and expertise to Dirigo Health upon
request.
[PL 2003, c. 469, Pt. A, §8 (NEW); PL 2003, c. 689, Pt. B, §6 (REV).]
8. Legal counsel. The Attorney General, when requested, shall furnish any legal assistance,
counsel or advice Dirigo Health requires in the discharge of its duties.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
9. Coordination with federal, state and local health care systems. Dirigo Health shall institute
a system to coordinate the activities of Dirigo Health with the health care programs of the Federal
Government and state and municipal governments.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
10. Initial staffing. Upon request from the board, the Governor shall provide staffing assistance
to Dirigo Health in the initial phases of its operation.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
11. Advisory committees. Dirigo Health may appoint advisory committees to advise and assist
Dirigo Health. Members of an advisory committee serve without compensation but may be reimbursed
by Dirigo Health for necessary expenses while on official business of the advisory committee.
[PL 2003, c. 469, Pt. A, §8 (NEW).]
12. Legislative jurisdiction. Notwithstanding any provision of law to the contrary, legislative
jurisdiction for oversight of Dirigo Health is governed by the Joint Rules of the Legislature. In adopting
the joint rules, the Legislature shall give consideration to ensuring that legislative oversight of Dirigo
Health is thorough and ongoing, that normal budgetary procedures and controls are exercised and that
committee jurisdiction is consistent with the subject matter jurisdiction of the joint standing
committees.
[PL 2005, c. 394, §3 (NEW).]
12. (TEXT REALLOCATED TO T. 24-A, §6908, sub-§13) Report; jurisdiction.
[PL 2005, c. 400, Pt. A, §5 (NEW); PL 2005, c. 683, Pt. B, §20 (RAL).]
13. (TEXT REALLOCATED FROM T. 24-A, §6908, sub-§12) Report; jurisdiction. Dirigo
Health shall report twice annually, once in January and once during the last month of the regular

legislative session, to the joint standing committee of the Legislature having jurisdiction over insurance
and financial services matters on the Dirigo Health Program and budget. Minutes of meetings of the
Board of Trustees of Dirigo Health must be provided to each member of the joint standing committees
of the Legislature having jurisdiction over insurance and financial services matters, health and human
services matters and appropriations and financial affairs.
[PL 2007, c. 447, §7 (AMD).]

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