Public Laws

124th Legislature

Second Regular Session


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Chapter 571

H.P. 1183 - L.D. 1671

PART PPPP

Sec. PPPP-1. Mental health and substance abuse outpatient services working group. The Department of Health and Human Services shall convene a working group of stakeholders to conduct a study and make recommendations regarding the delivery of mental health and substance abuse outpatient services. The study must evaluate the relative costs associated with the delivery of these services in the hospital outpatient setting and through community mental health and substance abuse agencies. The department shall gather data on the payer-mix for these services in both settings, including the number of uninsured individuals. The study must identify the differences between each setting concerning regulatory, licensing and accreditation requirements. The department shall develop research on the types of services provided, programmatic scope in each setting and availability of these services across all payers in each setting.

The study must also include the following:

1. A description of outpatient mental health and substance abuse services that are reimbursable under MaineCare rules;

2. A description of outpatient mental health and substance abuse services provided by hospitals specifically identifying how they differ from the services provided by nonhospital providers as described in departmental rule;

3. A description of current payment systems and rates, including but not limited to claims data for hospital and nonhospital providers of outpatient mental health and substance abuse services;

4. A description of how payment systems and rates for outpatient mental health and substance abuse services provided by hospitals will change if the hospitals are reimbursed via ambulatory payment classifications rather than as state plan services;

5. A description of outcomes and quality of the services delivered in hospital versus nonhospital settings; and

6. A description of administrative costs incurred by hospital and nonhospital providers of outpatient mental health and substance abuse services.

The working group shall provide a report to the joint standing committee of the Legislature having jurisdiction over appropriations and financial affairs and the joint standing committee of the Legislature having jurisdiction over health and human services matters no later than January 15, 2011, including the data and analysis requested and its findings and recommendations regarding preserving access to mental health and substance abuse outpatient services and the relative effect of services provided in settings described in this section on MaineCare spending. The study must include any information regarding the effect on the payment for these services if the department implements managed care for the MaineCare program.

Office of the Revisor of Statutes
State House, Room 108
Augusta, ME 04333