HP0680, LD 967, item 3, Document Text

Amend the bill in section 1 in §3195 in subsection 2 in paragraph B in the 4th line (page 2, line 2 in L.D.) by inserting after the following: " program;" the following: ' and'

Amend the bill in section 1 in §3195 in subsection 2 by striking out all of paragraphs C and D (page 2, lines 3 to 11 in L.D.).

Amend the bill in section 1 in §3195 in subsection 2 by relettering the paragraphs to read alphabetically.

Amend the bill by inserting after section 1 the following:

‘Sec. 2. Immediate rate increases. The Department of Health and Human Services shall increase reimbursement rates in accordance with this section.

1. Section 21 rules. No later than October 1, 2017, the Department of Health and Human Services shall amend its rules to increase reimbursement rates by 10% over the reimbursement levels implemented in 2007 pursuant to Public Law 2005, chapter 12, Part CCCC, section 1 for the following procedure codes provided in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 21:

A. T2017 home support;

B. T2017 SC home support with medical add-on;

C. T2017 GT home support - remote support;

D. T2016 agency home support;

E. T2016 agency home support over 168 hours;

F. T2016 SC agency home support with medical add-on;

G. S5140 shared living foster care, adult, one member;

H. S5140 TG shared living foster care, adult, one member, increased level of support;

I. S5140 UN shared living foster care, adult, 2 members;

J. S5140 UN TG shared living foster care, adult, 2 members, increased level of support;

K. T2021 community support;

L. T2021 SC community support with medical add-on;

M. T2015 career planning;

N. T2019 employment specialist services;

O. T2019 SC employment specialist services with medical add-on;

P. H2023 work support, individual;

Q. H2023 SC work support with medical add-on;

R. H2023 UN work support, group, 2 members;

S. H2023 UP work support, group, 3 members;

T. H2023 UQ work support, group, 4 members;

U. H2023 UR work support, group, 5 members;

V. H2023 US work support, group, 6 members; and

W. T2034 crisis intervention services.

2. Section 29 rules. No later than October 1, 2017, the Department of Health and Human Services shall amend its rules to increase reimbursement rates by 10% over the reimbursement levels implemented in 2007 pursuant to Public Law 2005, chapter 12, Part CCCC, section 1 for the following procedure codes provided in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 29:

A. T2017 home support, 1/4 hour;

B. T2017 GT home support, remote support;

C. T2021 community support;

D. T2021 SC community support with medical add-on;

E. T2019 employment specialist services;

F. T2019 SC employment specialist services with medical add-on;

G. H2023 work support, individual;

H. H2023 SC work support - supported employment with medical add-on;

I. H2023 UN work support, group, 2 members;

J. H2023 UP work support, group, 3 members;

K. H2023 UQ work support, group, 4 members;

L. H2023 UR work support, group, 5 members;

M. H2023 US work support, group, 6 members;

N. T2015 career planning;

O. S5150 respite, 1/4 hour; and

P. S5151 respite, per diem.

3. Major substantive rules. Rules adopted pursuant to this section are major substantive rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A.

Sec. 3. Savings efforts. The Department of Health and Human Services and representatives of organizations of providers of community support services for individuals with intellectual disabilities and autism shall examine current reimbursement rates, costs of providing services, labor costs and administrative overhead costs to determine opportunities for efficiencies and savings. The department and providers shall present a report to the Joint Standing Committee on Health and Human Services with findings no later than January 1, 2018.

Sec. 4. Appropriations and allocations. The following appropriations and allocations are made.

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS)

Developmental Services Waiver - MaineCare 0987

Initiative: Provides appropriations due to a change in the rates provided for home-based and community-based care for individuals with intellectual disabilities or autism.

GENERAL FUND 2017-18 2018-19

All Other
$23,363,478 $23,371,358

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GENERAL FUND TOTAL $23,363,478 $23,371,358

Developmental Services Waiver - Supports Z006

Initiative: Provides appropriations due to a change in the rates provided for home-based and community-based care for individuals with intellectual disabilities or autism.

GENERAL FUND 2017-18 2018-19

All Other
$3,159,904 $3,160,970

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GENERAL FUND TOTAL $3,159,904 $3,160,970

Medicaid Services - Developmental Services 0705

Initiative: Provides allocations due to a change in the rates provided for home-based and community-based care for individuals with intellectual disabilities or autism.

OTHER SPECIAL REVENUE FUNDS 2017-18 2018-19

All Other
$5,367,295 $5,367,295

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OTHER SPECIAL REVENUE FUNDS TOTAL $5,367,295 $5,367,295

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS)

DEPARTMENT TOTALS 2017-18 2018-19

GENERAL FUND
$26,523,382 $26,532,328

OTHER SPECIAL REVENUE FUNDS
$5,367,295 $5,367,295

inline graphic sline.gif

DEPARTMENT TOTAL - ALL FUNDS $31,890,677 $31,899,623

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)

Medical Care - Payments to Providers 0147

Initiative: Provides allocations due to a change in the rates provided for home-based and community-based care for individuals with intellectual disabilities or autism.

FEDERAL EXPENDITURES FUND 2017-18 2018-19

All Other
$57,564,238 $57,555,293

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FEDERAL EXPENDITURES FUND TOTAL $57,564,238 $57,555,293

Office of MaineCare Services 0129

Initiative: Provides appropriations and allocations for the Department of Administrative and Financial Services, Office of Information Technology to update and test changes to the Enterprise Information System.

GENERAL FUND 2017-18 2018-19

All Other
$38,160 $0

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GENERAL FUND TOTAL $38,160 $0

FEDERAL EXPENDITURES FUND 2017-18 2018-19

All Other
$38,160 $0

inline graphic sline.gif

FEDERAL EXPENDITURES FUND TOTAL $38,160 $0

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)

DEPARTMENT TOTALS 2017-18 2018-19

GENERAL FUND
$38,160 $0

FEDERAL EXPENDITURES FUND
$57,602,398 $57,555,293

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DEPARTMENT TOTAL - ALL FUNDS $57,640,558 $57,555,293

SECTION TOTALS 2017-18 2018-19

GENERAL FUND
$26,561,542 $26,532,328

FEDERAL EXPENDITURES FUND
$57,602,398 $57,555,293

OTHER SPECIAL REVENUE FUNDS
$5,367,295 $5,367,295

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SECTION TOTAL - ALL FUNDS $89,531,235 $89,454,916

’

SUMMARY

This amendment directs the Department of Health and Human Services to increase reimbursement rates by 10% over the reimbursement levels implemented in 2007 pursuant to Public Law 2005, chapter 12, Part CCCC, section 1 for services provided under Chapter 101: MaineCare Benefits Manual, Chapter III, Sections 21 and 29 no later than October 1, 2017. The amendment narrows the services that are reimbursed to codes that provide direct support services to the MaineCare members receiving services under the waiver programs. It also directs the department and representatives of organizations of providers of community support services for individuals with intellectual disabilities and autism to examine reimbursement rates, costs of providing services and other costs to determine opportunities for efficiencies and savings. The department and the providers are required to report findings to the Joint Standing Committee on Health and Human Services no later than January 1, 2018. This amendment also adds an appropriations and allocations section.

FISCAL NOTE REQUIRED

(See attached)

HP0680 LD 967	Session - 128th Maine Legislature C "A", Filing Number H-342, Sponsored by		LR 1785 Item 3
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GENERAL FUND	2017-18	2018-19
All Other	$23,363,478	$23,371,358

GENERAL FUND TOTAL	$23,363,478	$23,371,358

OTHER SPECIAL REVENUE FUNDS	2017-18	2018-19
All Other	$5,367,295	$5,367,295

OTHER SPECIAL REVENUE FUNDS TOTAL	$5,367,295	$5,367,295

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS)
DEPARTMENT TOTALS	2017-18	2018-19

GENERAL FUND	$26,523,382	$26,532,328
OTHER SPECIAL REVENUE FUNDS	$5,367,295	$5,367,295

DEPARTMENT TOTAL - ALL FUNDS	$31,890,677	$31,899,623

FEDERAL EXPENDITURES FUND	2017-18	2018-19
All Other	$57,564,238	$57,555,293

FEDERAL EXPENDITURES FUND TOTAL	$57,564,238	$57,555,293

SECTION TOTALS	2017-18	2018-19

GENERAL FUND	$26,561,542	$26,532,328
FEDERAL EXPENDITURES FUND	$57,602,398	$57,555,293
OTHER SPECIAL REVENUE FUNDS	$5,367,295	$5,367,295

SECTION TOTAL - ALL FUNDS	$89,531,235	$89,454,916