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Maine's universal coverage plan could burden state physicians.(Electronic Claims Required)

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| August 01, 2003 | Silverman, Jennifer | COPYRIGHT 2003 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.  All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)Copyright

A universal health care plan that promises to cover Maine's uninsured in 5 years could bring added hassles to that state's physicians.

They'll have to be more prudent about their medical records, disclosing charges to patients, and submitting claims under this ambitious program, Gordon Smith, executive vice president of the Maine Medical Association, told this newspaper.

The Maine legislature in June approved the nation's first universal health plan with a goal to cover the state's 180,000 uninsured citizens by 2009. The public-private insurance program, known as "Dirigo Health," will offer low-cost health plans to individuals, small businesses, and the self-employed through private insurance carriers. "Dirigo," part of Maine's motto, means "I direct" in Latin.

MaineCare, the state's Medicaid program, will be expanded to cover more low-income adults and children. Those with incomes below 300% of the federal poverty level are eligible for health care subsidies on a sliding scale based on ability to pay. The program would be supplemented by federal grants, federal Medicaid funds, and payments by subscribers and participating businesses. The state also expects to save $80 million annually by eliminating unreimbursed care for the uninsured.

While the new plan isn't with out its perks--it includes $500,000 to increase the physician incentive program within MaineCare--some provisions of the law have physicians worried, Mr. Smith said.

One provision requires physicians to submit claims electronically through the use of standardized forms.

It also allows carriers to reject claims that are not submitted electronically.

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