This bill establishes a managed care program for MaineCare services. The bill requires the Department of Health and Human Services to issue a request for proposals to contract with 3 managed care organizations to provide MaineCare services. Managed care refers to a system of delivering services through arrangements with selected providers to furnish health care services and financial incentives for patients to use the participating providers and procedures included in the managed care program. The model also requires that the department reimburse the managed care organizations primarily using negotiated monthly rate per enrollee, rather than a fee-for-service model. The bill establishes a number of requirements for developing the procurement process and essential contract terms. The bill establishes deadlines by which specific categories of eligible enrollees must be enrolled in the managed care program, beginning February 1,
2029. The department must submit a report to the Legislature by December 3, 2025 detailing its plan for implementing the program within the timeline established by this legislation. The bill also includes a deadline of April 1, 2026, by which time the department must submit all waivers and amendments for the state Medicaid plan that are necessary to implement this legislation. The department is authorized to adopt rules. Rules adopted are considered major substantive rules under the Maine Administrative Procedure Act.