Health facilities cost review board-consumer membership

MAINE STATE LEGISLATURE The following document is provided by the LAW AND LEGISLATIVE DIGITAL LIBRARY at the Maine State Law and Legislative Reference Library http://legislature.maine.gov/lawlib Reproduced from scanned originals with text recognition applied (searchable text may contain some errors and/or omissions) RICH.\1W 3. COREN ATTOHi'i!::Y GEN::RAL S·r.\TE OF MA!Nt!: DSPAR'I'"'vtEl'i'l' OF nm ATTORNEY GENERAL Al'GLTSTA. MAlNE 04333 Feb~uary 15, 1979 Honorable Sandra Prescott House of Representatives State House Augusta, Maine 04333 ;Jo'!~/ ]VI. R. PA'l'f.:HSON o,::PUTY i\ fTOi'(N::Y GENERAi_ Re: Health Facilit:Le:s Cost Re-View Board-Consumer Membership Dear Representative Prescott: On February 14, 1979, you orally requested an inter- pretation of language appearing in the Health Facilities Information Dis6losure Act. sse 22 M.R.S.A. §§351 to 370 (1978 Supp.). Your opinion request relates to the composi- tion of the Health Facilities Cost Review Board, which con- sists o:E ±0 membars, 8 :>f whom are to be appointed by the Governor. - The 8 appointed members are to be chosen from the following fields; one from a list submi.tted by the Maine Hospital Association; one from a list submitted from the Maine Health Care Association; one from the field of health insurance or health care administration; five from the public who are heal tn care con3umers. Your spec;Lf ic opinion request is concerned with that provision of 22 M.R.S.A. §353 which governs the appointment of the five consumer members of the Health Facilities Cost Review Board. 22 M.R.S.A. §353(1) (D) (1978 Supp.) provides: "Five public members shall be appointed as consumers of health care. Neither the public members nor their spouses or children shall, within the preceding 12 months, have been affil- l. The other two members are the Commissioner of Human Services or his des:·.gnee and the Superi1J l:endent of Insurance or his designee; The former serves as an ex officio voting rr.err.ber of the Board while the latter serves as an ex officio non-voting member of the Board. 22 M.R.S.A. §353. -I i I - 7 - iated with, employed by, or have.had any professional affiliatio~ with any heal~h cars facility or institution, health product manu- facturer or corporation or insurer p:,:,.;,ri.din~J coverage for hospital o.c medical care. 11 2 Your opinion request is two-fold. First, whether a person who meets all the requirements of being a."consumer of health care" within the meaning of section 353(1) (D) but who holds an insurance policy providing for health and/or medical care coverage is disqualified from serving as a consumer member on either the Health Facilities Cost Review Board or the Vol-·· untary Budget Review Organization. Second, you have inquired whether a person who serves as a corporator or as a member of an honorary board of a health care facility or institution is · disqualified from being appointed as a consumer member of the boardsreferred to above. It is well-established that in interpreting a statute, the paramount consideration is the intent of the enacting body. State Development Office v. State Employees Appeal Board, Me., 363 A.2d 688(1976); Finks v. Maine State Highway Commission, Me., 328 A.2d 791(1974). In asc~rtaining legislative intent regard- ing a particular statutory enactment, it is proper to examine the relevant· statutory history. See State v. Norton, .Me., 335 A.2d 607(1975). Additionally, words used in a statute should be given their common and ordinary sense meaning, unless a different meaning was intended by the Legislature. See, e.g., Union Mutual Life Insurance Co. v. Emerson, Me., 345-X-::-2d 504 (1975); Frost v. Lucey, Me., 231 A.2d 441(1967). Language in a statute should be interpreted so as to give effect to and promote, not frustrate, the purposes of the legislation. Town uf A:ru~1del v . .Swain, Me., 374 i\..2d 317(:i..977); N&t2,::;_e v. Kenn-Z.: bunkport Board of zoning Appeals, Me., 363 A.2d 1372(1976). Finally, it should be kept in mind that it is a basic tenet of statutory construction that the Legislature does not intend to accomplish absurd results or to enact useless legislation. See, e.g. Land Management, Inc. v. Department of Environmental Protec- tion,Me., 368 A.2d 602(1977); State v. Larrabee, 156 Me., 115, .161-A. 2d 855 ( 1960) . --·· With the for~going general background in mindi it is now appropriate to examine the legislative history o::: 22 M.R.S .• A. §353(1978 Supp.). The Legislation was originally proposed in L.D.2136. During the course of the debate on this bill, Repre- sentative Harlan Goodwin, who spoke in favor of the majority report, discussed the composition of the Health Facilities Cost Review Board and, in particular, the consumer members thereof. 2. 22 M.R.S.A.§364(2) (B) and (7) (A) (1978 Supp.) contains lang- uage identical to that quoted above, but refer to the com- position of voluntary budget review organizations. - 3 - Representative Goodwin stated; "five members shall be appoi.nt:.cd as consurTters of health cax:e who have no direct affiliution with any heal th care fucili ty u:r. in~; tituti.on. 11 ·( emphasir~ supplied). ~;,::.:c Leg. Rec. at pa9e 604, March l6r 1978. M.ore- over, Represen.Eative Kane, who supported the minority report, discussed the composition of the Voluntary Budg~t Review Organization in the following· terms: " ••• [T]here would be one-third representation from the hospitals; one-third consumers and one- third, third party payers. Anyone on the Comm- ittee who has been involved in this knows that there is nobody hotter to trot on rate regulation then [sic] third-party payers, which is principally Blue Cross-Blue Shield. Although there are not a major~ ity of consumers on the board, it is not a majority of hospitals either. It is only one-third hospitals, and for something that is supposed to be their own board, they don't even control it. 11 Leg. Rec. at pag-e 608, March 16, 197 8. It would appear from the foregoing that in establishing the qualifications for-consumer membership on either the Health Facilities Cost Review Board or the Voluntary Budget Review Organizationr the Legislature was primarily concerned in assuring that the "public members" truly represented consumers of health care. Consequently, as Representative Goodwin pointed out during the debate on L.D.2136f neither consumer members nor their imm- ediate families could have any direct affiliation with health care facilities or insurance carriers. Analyzin~ the language in section 353(1) (D) in a common sense fashion with an eye toward furthering the overall purpose of the Health Facilities Informa- tion Disclosure Act, it is my conclusion that the holding of a hGalth care insurance pol~cy, in and of itself, ~oes not dis- qualify a person from serving as a consumer member of the Board. To hold to the contrary would disqualify the vast majority of otherwise eligible citizens of the state, who are truly repre- sentative of consumer interests. The legislative debate on L.D. 2136 makes it clear that third-party payers and health care con- sumers were viewed as separate and distinct groups who represented different interests. Simply because a consumer purchases, or is otherwise covered under, an insurance policy does not mean that he is "affiliated" with that insurer within the meaning of section 353 (1) (D) . I reach an opposite conclusion with respect to corporators or members on an honorary board of a health care facility or institution. These individuals have a direct and substantial connection with the health care field. In some instances, these individuals mqy be intimately associated with a hospital or other health care institution. The affiliation of such individuals with a health care facility or institution is likely to be of a direct nature such that they do not accurately _represent the -· 4 - views of th0, heal th care consumers. In other wo:i::ds, the attit.udes and views of snch individuals may tend to coincide more with those of the health ~are facility with whjch tt~y a.:::-e associated than with the. c:onsumer they are expected to represent. This would be the type of "direct'i affiliation which section 353 (1) (D) contem'()lates as disqualifying one from consumer membership on either the Health Facilities Cost Review Board or the Voluntary Budget Review Organization. I hope this information is helpful to you and please feel free to contact me again if you should need my assistance. WRS ~ sm Sincerely, WILLIAM R. STOKES Assistant Attorney General