Sec. A-1. 22 MRSA §3174-G, sub-§1, ¶¶D and E, as enacted by PL 1999, c. 731, Pt. OO, §1, are amended to read:
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.; and
Sec. A-2. 22 MRSA §3174-G, sub-§1, ¶F is enacted to read:
F. A person 20 to 64 years of age who is not otherwise covered under paragraphs A to E when the person's family income is below or equal to 100% of the nonfarm income official poverty line, provided that the commissioner shall adjust the maximum eligibility level in accordance with the requirements of the paragraph.
(1) If, on October 1, 2003 and annually thereafter, expenditures for the population described in this paragraph are reasonably anticipated to fall below the program budget, the commissioner shall raise the maximum eligibility level to the extent necessary to provide coverage to as many persons with income below 125% of the nonfarm income official poverty line as possible within the fiscal constraints of the Maine Health Access Fund described in section 260.
(2) If the maximum eligibility level is raised above 100% of the poverty level pursuant to this paragraph and subsequently the commissioner reasonably anticipates the cost of the program to exceed the budget of the population described in this paragraph, the commissioner shall lower the maximum eligibility level to the extent necessary to provide coverage to as many persons as possible within the program budget.
(3) The commissioner shall give at least 30 days' notice of the proposed change in maximum eligibility level 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.
(4) The department must begin offering coverage 3 months after obtaining approval of a waiver of coverage from the United States Department of Health and Human Services or on October 1, 2002, whichever is later.
Sec. A-3. 22 MRSA §3174-T, sub-§2, ¶¶D and E, as reallocated by RR 1997, c. 2, §46, are amended to read:
D. Notwithstanding changes in the maximum eligibility level determined under paragraph B, the following requirements apply to enrollment and eligibility:
(1) Children must be enrolled for 6-month 12-month enrollment periods. Prior to the end of each 6-month 12-month enrollment period the department shall redetermine eligibility for continuing coverage; and
(2) Children of higher family income may not be covered unless children of lower family income are also covered. This subparagraph may not be applied to disqualify a child during the 6-month 12-month enrollment period. Children of higher income may be disqualified at the end of the 6-month 12-month enrollment period if the commissioner has lowered the maximum eligibility level under paragraph B.
E. Coverage under the Cub Care program may be purchased for children described in subparagraphs (1) and (2) for a period of up to 18 months as provided in this paragraph at a premium level that is revenue neutral and that covers the cost of the benefit and a contribution toward administrative costs no greater than the maximum level allowable under COBRA. The department shall adopt rules to implement this paragraph. The following children are eligible to enroll under this paragraph:
(1) A child who is enrolled under paragraph A or B and whose family income at the end of the child's 6-month 12-month enrollment term exceeds the maximum allowable income set in that paragraph; and
(2) A child who is enrolled in the Medicaid program and whose family income exceeds the limits of that program. The department shall terminate Medicaid coverage for a child who enrolls in the Cub Care program under this subparagraph.
Sec. A-4. 22 MRSA §§3174-AA and 3174-BB are enacted to read:
Beginning January 1, 2002, in determining eligibility for medical assistance under the Medicaid program for all individuals and families subject to an asset test, the department shall exempt from consideration all assets exempt pursuant to program rule on January 1, 2001 and shall adopt rules to exempt from consideration certain assets in amounts and under terms the department determines to be reasonable and consistent with the purposes of the Medicaid program as provided in this section. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter II-A. The rules must provide exemptions for the following assets:
1. Second vehicle. A 2nd vehicle that is necessary for employment, to secure medical treatment or to provide transportation for essential daily activities or a vehicle that has been modified for operation by or the transportation of a person with a disability; and
2. Savings. An amount up to $8,000 for an individual and up to $12,000 for a household of more than one person.
The department shall establish enrollment periods for medical assistance as provided in this section. Prior to the end of the enrollment period, the department shall determine continuing eligibility for the next enrollment period and notify the enrollee of the determination.
1. Children. In the Medicaid program and the Cub Care program under section 3174-T, the enrollment period for children under 19 years of age must be 12 months.
2. Adults. In the Medicaid program, the enrollment period must be the longest period allowed by federal law or regulation but may not exceed 12 months.
Sec. A-5. Waiver. The Department of Human Services shall amend the waiver application from the State that is pending before the federal Department of Health and Human Services Health Care Financing Administration. The amended waiver must provide for maximum access to all prescription drugs covered by the Medicaid program, including drugs for the treatment of cancer.
Sec. A-6. Appropriation. The following funds are appropriated from the General Fund to carry out the purposes of this Part.
2001-02 2002-03
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers
All Other $3,347,990
Provides funds for Medicaid coverage to noncategorically eligible adults.
Medical Care - Payments to Providers
All Other $82,468 $118,347
Provides funds due to changes in the asset test used to determine eligibility for medical assistance under the Medicaid program.
Bureau of Health
All Other $410,000 $10,000
Provides funds to match available federal funding to promote the delivery of health care in rural areas of the State.
Bureau of Medical Services
Positions - Legislative Count (2.000)
Personal Services $91,558
All Other $25,000 68,744
____________ ____________
Total $25,000 $160,302
Provides funds for one Social Services Program Manager position and one Comprehensive Health Planner II position in fiscal year 2002-03 and related operating costs associated with expanding the access to the Medicaid program.
Bureau of Family Independence
Positions - Legislative Count (9.000)
Personal Services $364,656
All Other 76,500
____________
Total $441,156
Provides funds for 7 Family Independence Specialist positions, one Family Independence Unit Supervisor position and one Clerk Typist II position in fiscal year 2002-03 and related operating costs associated with expanding the access to the Medicaid program.
DEPARTMENT OF HUMAN SERVICES ____________ ____________
TOTAL $117,468 $4,077,795
Sec. A-7. Allocation. The following funds are allocated from the Federal Expenditures Fund to carry out the purposes of this Part.
2001-02 2002-03
HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers
All Other $6,669,932
Provides funds for the federal match for Medicaid coverage to noncategorically eligible adults.
Medical Care - Payments to Providers
All Other $163,448 $235,772
Provides funds for the federal match due to changes in the asset test used to determine eligibility for medical assistance under the Medicaid program.
Bureau of Medical Services
Positions - Legislative Count (2.000)
Personal Services 91,558
All Other $25,000 $68,744
____________ ____________
Total $25,000 $160,302
Provides funds for one Senior Medical Claims Adjuster position and one Social Services Program Specialist I position in fiscal year 2002-03 and related operating costs associated with expanding the access to the Medicaid program.
Bureau of Family Independence
Positions - Legislative Count (9.000)
Personal Services $364,656
All Other 76,500
____________
Total $441,156
Provides funds for 6 Family Independence Specialist positions, 2 Family Independence Unit Supervisor positions and one Clerk Typist II position in fiscal year 2002-03 and related operating costs associated with expanding the access to the Medicaid program.
DEPARTMENT OF HUMAN SERVICES ____________ ____________
TOTAL $188,448 $7,507,162
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