Sec. OO-1. 22 MRSA §3174-G, sub-§1, as amended by PL 1997, c. 777, Pt. A, §1, is repealed and the following enacted in its place:
1. Delivery of services. The department shall provide for the delivery of federally approved Medicaid services to the following persons:
A. A qualified woman during her pregnancy and up to 60 days following delivery when the woman's family income is equal to or below 200% of the nonfarm income official poverty line;
B. An infant under one year of age when the infant's family income is equal to or below 185% of the nonfarm income official poverty line;
C. A qualified elderly or disabled person when the person's family income is equal to or below 100% of the nonfarm income official poverty line;
D. A child one year of age or older and under 19 years of age when the child's family income is equal to or below 150% of the nonfarm income official poverty line; and
E. The parent or caretaker relative of a child described in paragraph B or D when the child's family income is equal to or below 150% of the nonfarm income official poverty line, subject to adjustment by the commissioner under this paragraph. Medicaid services provided under this paragraph must be provided within the limits of the program budget. Funds appropriated for services under this paragraph must include an annual inflationary adjustment equivalent to the rate of inflation in the Medicaid program. On a quarterly basis, the commissioner shall determine the fiscal status of program expenditures under this paragraph. If the commissioner determines that expenditures will exceed the funds available to provide Medicaid coverage pursuant to this paragraph, the commissioner must adjust the income eligibility limit for new applicants to the extent necessary to operate the program within the program budget. If, after an adjustment has occurred pursuant to this paragraph, expenditures fall below the program budget, the commissioner must raise the income eligibility limit to the extent necessary to provide services to as many eligible persons as possible within the fiscal constraints of the program budget, as long as the income limit does not exceed 150% of the nonfarm income official poverty line.
For the purposes of this subsection, the "nonfarm income official poverty line" is that applicable to a family of the size involved, as defined by the federal Department of Health and Human Services and updated annually in the Federal Register under authority of 42 United States Code, Section 9902(2). For purposes of this subsection, "program budget" means the amounts available from both federal and state sources to provide federally approved Medicaid services.
Sec. OO-2. 22 MRSA §3762, sub-§8, ¶A, as amended by PL 1997, c. 795, §7, is further amended to read:
A. The department shall administer a program of transitional Medicaid to families receiving benefits under Section 1931 of the federal Social Security Act in accordance with this paragraph.
(1) The department shall provide transitional Medicaid to families whose average gross monthly earnings, less costs to the family for child care necessary for employment, do not exceed 185% of the federal poverty guidelines in accordance with PRWORA and this subsection. In order to receive transitional Medicaid as the result of increased earnings or number of hours worked, a family must have received TANF Medicaid assistance for at least 3 of the last 6 months, except as provided in subparagraph 2 (2).
(2) The department shall provide transitional Medicaid for families whose eligibility for TANF Medicaid assistance terminated due to employment obtained through work search activities pursuant to this chapter, in which case the family must have received TANF Medicaid assistance for at least one of the last 3 months.
(3) To continue to receive transitional Medicaid assistance following the first 6 months of coverage, a family entering the transitional Medicaid program prior to federal approval or waiver under subparagraph 4 with income above 133% of the federal poverty guidelines must pay premiums in accordance with rules adopted by the department. If a family entering the transitional Medicaid program after federal approval or waiver has average gross monthly earnings, less average monthly costs for such child care as is necessary for employment, that are above 100% of the federal poverty guidelines, then that family shall pay, beginning in their 7th month of receiving transitional Medicaid, monthly premiums, copayments or other methods of cost sharing equal to no more than 3% of that family's average gross monthly earnings, less the average monthly costs for such child care as is necessary for employment.
(4) By October 1, 1997, the department shall have taken reasonable steps to seek a federal waiver, approval of a state plan modification under Section 114 of PRWORA or any other appropriate action to secure federal approval to use federal matching funds to extend transitional Medicaid assistance for 2 years beyond the families' initial 1-year period of eligibility. Beginning on February 1, 1998, or at the time that the department receives the federal approval or waiver, whichever is later, the department shall provide extended benefits under this subparagraph to families that qualify under subparagraph (1) or (2) and that meet the requirements of the transitional Medicaid program.
(5) The department shall provide transitional Medicaid for 4 months to families whose eligibility for TANF Medicaid assistance terminated due to an increase in the amount of child support received by the family.
(6) The department shall require reporting of income or circumstances for the purpose of determining eligibility and premium payments, copayments or other methods of cost sharing for benefits under this paragraph in accordance with rules adopted by the department.
(7) The scope of services provided under this paragraph must be the same as the scope of services provided when a family received TANF Medicaid assistance.
Sec. OO-3. Allocation. The following funds are allocated from Other Special Revenue funds to carry out the purposes of this Part.
2000-01
HUMAN SERVICES, DEPARTMENT OF
Bureau of Medical Services
Positions - Legislative Count (1.000)
Personal Services $21,544
All Other 2,250
_______
TOTAL $23,794
Provides funds from the Fund for a Healthy Maine for the state share of a Management Analyst II position and related operating costs to aid in managing Medicaid coverage.
Medical Care - Payments to Providers
All Other $3,645,925
Provides funds from the Fund for a Healthy Maine for the state share of the cost of expanding Medicaid coverage and for modifying transitional Medicaid assistance.
DEPARTMENT OF HUMAN SERVICES __________
TOTAL $3,669,719
Sec. OO-4. Allocation. The following funds are allocated from the Federal Expenditures Fund to carry out the purposes of this Part.
2000-01
HUMAN SERVICES, DEPARTMENT OF
Bureau of Medical Services
Personal Services $21,544
All Other 2,250
______
TOTAL 23,794
Provides funds for the federal share of a Management Analyst II position and related operating costs to aid in managing Medicaid coverage.
Medical Care - Payments to Providers
All Other 7,146,021
Provides funds for the federal share of expanding Medicaid coverage and for modifying transitional Medicaid assistance.
Medical Care - Payments to Providers
All Other 1,164,449
Provides funds for the federal share of the costs to provide Medicaid access to pregnant women.
DEPARTMENT OF HUMAN SERVICES __________
TOTAL $8,334,264
Sec. OO-5. Allocation. The following funds are allocated from Other Special Revenue funds to carry out the purposes of this Part.
2000-01
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers
All Other $596,000
Provides funds from the Fund for a Healthy Maine for the costs to provide access to Medicaid for pregnant women.
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