Updated Proposal on Board Composition Requirements for MHDO
The proposal addresses the board composition requirements outlined in the PL 2023, Chapter 584 (LD 1740) to ensure access to affordable healthcare. It includes new requirements for hospital price transparency and compliance with federal regulations, along with consequences for non-compliance and steps for corrective action by hospitals. The Maine Health Data Organization plays a key role in enforcing these regulations.
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Content Content Review Updated Proposal Regarding Board Composition Review Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices Board Meeting Schedule for CY 2025 Update on Maine Quality Forum 1 MHDO BOARD MEETING DECEMBER 5, 2024
Proposal Regarding MHDO Board Composition Refer to draft legislative language 2 MHDO BOARD MEETING DECEMBER 5, 2024
New Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices PART B 1718-I. Hospital price transparency 1. Compliance with federal regulations. A hospital must comply with the price transparency requirements established in 45 Code of Federal Regulations, Part 180, Subparts A and B, as in effect on January 1, 2024. 2. Standard format; rules. A hospital must provide price transparency data in a standardized format established in rule by the Maine Health Data Organization. The Maine Health Data Organization shall adopt by rule a standardized format for a hospital to disclose price transparency data that is the same or substantially similar to any format required by federal regulations. Rules adopted pursuant to this subsection are routine technical rules as described in Title 5, chapter 375, subchapter 2-A. 3 MHDO BOARD MEETING DECEMBER 5, 2024
New Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices 3. Failure to comply. A hospital that fails to comply with subsection 2 or any rule adopted by the Maine Health Data Organization may be subject to a fine for failure to comply under section 8705-A. Notwithstanding any provision of law to the contrary, the Maine Health Data Organization shall retain any fine collected from a hospital for a failure to comply with this section pursuant to a compliance action taken under section 8705-A. 4 MHDO BOARD MEETING DECEMBER 5, 2024
New Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices 4. Determination of material compliance; notice. Upon a determination that a hospital is not in material compliance with subsections 1 and 2, the Maine Health Data Organization shall notify the hospital that the hospital is not in material compliance and require the hospital to take corrective action within 60 days to become materially compliant. The Maine Health Data Organization shall adopt by rule standards for material compliance that align with federal regulations. Rules adopted pursuant to this subsection are routine technical rules as described in Title 5, chapter 375, subchapter 2-A. 5 MHDO BOARD MEETING DECEMBER 5, 2024
New Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices 45 Code of Federal Regulations PART 180 HOSPITAL PRICE TRANSPARENCY 180.40 General requirements. A hospital must make public the following: (a) A machine-readable file containing a list of all standard charges for all items and services as provided in 180.50. (specific requirements defined) (b) A consumer-friendly list of standard charges for a limited set of shoppable services as provided in 180.60. (specific requirements defined) Frequency of updates. The hospital must update the standard charge information described in both sections at least once annually. 6 MHDO BOARD MEETING DECEMBER 5, 2024
Maine Hospitals and 45 Code of Federal Regulations, Part 180, Subparts A and B Hospital System Hospital Machine Readable File Shoppable Services Effective Date/ Last Updated 8/1/2023 Cary Medical Center https://www.carymedicalcenter.org/fina nce-billing/hospital-pricing/ https://www.cmhc.org/patients-and- visitors/billing-financial- information/price-transparency/ https://www.cmhc.org/patients-and- visitors/billing-financial- information/price-transparency/ https://www.cmhc.org/patients-and- visitors/billing-financial- information/price-transparency/ https://www.dech.org/hospital-price- estimate/ Downloadable file at same link Cary Medical Center Central Maine Healthcare Price Estimate tool: https://cmhc.patientsimple.com/guest/#/e stimates/patientestimate#1 Price Estimate tool: https://cmhc.patientsimple.com/guest/#/e stimates/patientestimate#1 Price Estimate tool: https://cmhc.patientsimple.com/guest/#/e stimates/patientestimate#1 Price estimator: https://www.patientsimple.com/dech/esti mates Downloadable file at same link 7/1/2024 Central Maine Medical Center Central Maine Healthcare 7/1/2024 Bridgton Hospital Central Maine Healthcare 7/1/2024 Rumford Hospital Down East Community Hospital Down East Community Hospital 7/1/2024 Houlton Regional Hospital MaineGeneral Health Houlton Regional Hospital https://houltonregional.org/billing- 2/price-transparency/ https://www.mainegeneral.org/patients- visitors/medical-fees-and-cost-of-care/ https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services 6/7/2024 https://ezcost.info/MaineGeneral-Medical- Center/estimate_cost Hospital Price Index 1/1/2024 MaineGeneral Medical Center MaineHealth 6/5/2024 MaineHealth Franklin Hospital MaineHealth Hospital Price Index 6/5/2024 MaineHealth Lincoln Hospital 7 MHDO BOARD MEETING DECEMBER 5, 2024
Maine Hospitals and 45 Code of Federal Regulations, Part 180, Subparts A and B Hospital System Hospital Machine Readable File Shoppable Services Effective Date/ Last Updated 6/5/2024 MaineHealth https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mainehealth.org/patients- visitors/billing-and-financial-services https://www.mrhme.org/patient- resources/hospital-pricing/ Hospital Price Index MaineHealth Maine Medical Center Biddeford/Sanford MaineHealth Maine Medical Center Portland MaineHealth Memorial Hospital MaineHealth Hospital Price Index 6/5/2024 MaineHealth Hospital Price Index 6/5/2024 MaineHealth Hospital Price Index 6/5/2024 MaineHealth Mid Coast Hospital MaineHealth Hospital Price Index 6/5/2024 MaineHealth Stephens Hospital MaineHealth Hospital Price Index 6/5/2024 MaineHealth Pen Bay Hospital MaineHealth Hospital Price Index 6/5/2024 MaineHealth Behavioral Health MaineHealth Hospital Price Index 6/5/2024 MaineHealth Waldo Hospital Millinocket Regional Hospital Millinocket Regional Hospital Downloadable file at same link. Patient Estimator: https://rcm.trubridge.com/remitreppcePor tal/EstimateGeneration?Guid=c98afaafc8af 4c79a4a49f1a942db894 7/1/2024 8 MHDO BOARD MEETING DECEMBER 5, 2024
Maine Hospitals and 45 Code of Federal Regulations, Part 180, Subparts A and B Hospital System Hospital Machine Readable File Shoppable Services Effective Date/ Last Updated 6/4/2024, 5/29/2024 Mount Desert Island Hospital https://www.mdihospital.or g/insurance-and- billing/pricing/ Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Machine Readable Files - Northern Light Health Downloadable file/patient estimator at same link Mount Desert Island Hospital Northern Light Health Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index Northern Light Mayo Hospital not included in estimator; link within the same page to the left. Patient estimator: https://northernlighthealth.patientsimple.com/guest/#/index 7/1/2024 Acadia Hospital Northern Light Health 7/1/2024 AR Gould Hospital Northern Light Health 7/1/2024 Blue Hill Hospital Northern Light Health 7/1/2024 CA Dean Hospital Northern Light Health 7/1/2024 Eastern Maine Medical Center Inland Hospital Northern Light Health 7/1/2024 Northern Light Health 7/1/2024 Maine Coast Hospital Northern Light Health 7/1/2024 Northern Light Mayo Hospital Mercy Hospital Northern Light Health 7/1/2024 9 MHDO BOARD MEETING DECEMBER 5, 2024
Maine Hospitals and 45 Code of Federal Regulations, Part 180, Subparts A and B Hospital System Hospital Machine Readable File Shoppable Services Effective Date/ Last Updated 7/1/2024 Northern Light Health Patient estimator: https://northernlighthealth.patientsimple .com/guest/#/index https://www.patientsimple.com/nmmc/es timates https://rcm.trubridge.com/remitreppceP ortal/EstimateGeneration?Guid=5f34ab2e 070d4b74b5d1b5f1bfd1a1a2 Downloadable file at same link Sebasticook Valley Hospital Machine Readable Files - Northern Light Health Northern Maine Medical Center Penobscot Valley Hospital https://nmmc.org/billing-and-financial- services/ (Under Pricing and Estimates tab) https://pvhme.org/patient- resources/price-transparency/ 7/2/2024 Northern Maine Medical Center Penobscot Valley Hospital 7/12/2024 Redington-Fairview General Hospital Covenant Health https://www.rfgh.net/patientinformation/p rice-transparency.xhtml https://stjosephbangor.org/pricing/ May 2024, 5/30/2024 Redington-Fairview General Hospital St. Joseph Healthcare in Bangor St. Mary s Health System, Lewiston, ME York Hospital https://mychart.covh.org/mychart/gueste stimates https://mychart.covh.org/mychart/gueste stimates Downloadable file at same link 7/1/2024 https://stmarysmaine.com/pricing/ 7/1/2024 Covenant Health York Hospital https://www.yorkhospital.com/patients- and-visitors/patient-price-list 2/1/2024, 6/4/2024 10 MHDO BOARD MEETING DECEMBER 5, 2024
New Requirements in PL 2023, Chapter 584 (LD 1740), An Act to Protect a Patient's Access to Affordable Health Care with Timely Access to Health Care Prices Next Steps Board authorizes Karynlee to initiate rulemaking (routine technical) to implement the requirements in PL 2023, Chapter 584, Section B. Tentative Schedule Public Hearing: April 3, 2024 Board reviews comments and votes to adopt: June 5, 2024 11 MHDO BOARD MEETING DECEMBER 5, 2024
Proposed Board Meeting Schedule CY 2025 February 6th April 3rd (Public Hearing & Board Meeting) June 5th September 4th December 4th Additional meetings may be added as needed 12 MHDO BOARD MEETING DECEMBER 5, 2024
Maine Quality Forum Key Deliverables Annual report on rate of healthcare associated infections in the State of Maine (completed in Q1 2025) Project First Line Deliverables Annual primary care spending report Draft Report e-mailed to advisory committee week of January 6th Annual behavioral health care spending report Draft Report e-mailed to advisory committee week of January 20th 13 MHDO BOARD MEETING DECEMBER 5, 2024
