Resolve, Regarding Legislative Review of Chapter 101: MaineCare Benefits Manual, Chapter III, Section 97, Private Non-medical Institution Services, a Major Substantive Rule of the Department of Human Services
Maine Legislature, Session 121, LD 1867
Committee Amendment CA_A_H882 (House)

COMMITTEE AMENDMENT ,A" to H.P. 1391, L.D. 1867, "Resolve, 
Regarding Legislative Review of Chapter 101: MaineCare Benefits 
Manual, Chapter III, Section 97, Private Non-medical Institution 
Services, 
a Major Substantive Rule of the Department of Human 
Services" 
Amend the resolve in section 1 in the last line (page 1, 
line 28 in L.D.) by striking out the following: "authorized." and 
inserting in its place the following: 
'authorized provided the 
following changes are made in Section 97. 
1. 
The principles of reimbursement in Section 97 must be 
changed to eliminate reduced reimbursement for private nonmedical 
institutions that use a calculation of bed-hold days for medical 
and remedial private nonmedical institution residents. 
In place 
of bed-hold days and in order to produce the same amount of 
savings 
for 
the 
MaineCare 
program, 
the 
principles 
of 
reimbursement for room and board in Section 115 must provide for 
a general rate reduction of 25 cents per resident per day in the 
facility-specific routine component of the room-and-board portion 
of payment. 
2. 
The principles of reimbursement must be changed in the 
wording 
exchange 
workers 
"stipend" 
fee." 
used 
to 
refer 
to 
reimbursement 
fellows of professional exchange 
in private nonmedical institution 
in the rule and appendices must be 
related 
to 
foreign 
programs for social 
settings: 
the word 
changed to "contract 
In order to accomplish the rule changes required by this 
resolve, the Department of Human Services shall adopt emergency 
rules to implement this resolve; and be it further' 
COMMITTEE AMENDMENT 
~t\~' 
,,' " 
COMMITTEE AMENDMENT ~ 
.. to H.P. 1391, L.D. 1867 
Further amend the resolve by inserting after section 1 the 
following: 
'Sec. 2. Appropriations and allocations. 
Resolved: 
following appropriations and allocations are made. 
BOMAR SERVICES, DEPARTMENT OF 
Medical Care -
Payments to Providers 
0147 
That the 
Ini tiati ve: 
Allocates funds to restore a Federal Expenditures 
Fund deal location as a result of replacing a Public Law 2003, 
chapter 
20, 
Part B, 
MaineCare private nonmedical institution 
(PNMI) payment reduction with a state-only room-and-board payment 
reduction. 
Federal Expenditures Fund 
All Other 
Federal Expenditures Fund Total 
SUMMARY 
2003-04 
$97,319 
$97,319 
2004-05 
$388,408 
$388,408' 
This 
amendment 
approves 
the 
major 
substantive 
rules 
submitted 
regarding 
MaineCare 
rates 
for 
private 
nonmedical 
institutions provided those rules are amended to use a 25-cent 
per resident per day rate reduction in the facility-specific 
routine component of the room-and-board portion of the payment in 
place of the reduced reimbursement, based on application of a 
bed-hold day decrease, that had been proposed. 
The amendment 
requires 
wording 
used 
to 
refer 
to 
reimbursement 
related to 
foreign exchange fellows of professional exchange programs for 
social workers 
to be 
changed: 
"stipend" must be 
changed to 
"contract fee." 
The amendment requires the Department of Human Services to 
adopt emergency rules to implement the rules as approved by the 
Legislature. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Appropriations! Allocations 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Approved: 04/07/04 :;t;?ae. 
Office of Fiscal and Program Review 
LD 1867 
Resolve, Regarding Legislative Review of Chapter 101: MaineCare 
Benefits Manual, Chapter III, Section 97, Private Non-medical 
Institution Services a Major Substantive Rule of the Department of 
Human Services 
LR2803(04) 
Fiscal Note for Bill as Amended by Committee Amendment" " 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
2003-04 
$97,319 
$97,319 
2004-05 
$388,408 
$388,408 
Projections 
2005-06 
$417,678 
$417,678 
Projections 
2006-07 
$451,093 
$451,093 
The amendment revises the original bill\rulemaking to replace the implementation of a rate reduction for medical and 
remedial PNMI bed-hold days (as included in PL 2003, c. 20, Pt. B), with a $0.25 per resident per day reduction in 
room and board payments. Assuming the bed-hold day provision remains in effect until the $0.25 per resident per day 
reduction in room and board payments becomes effective, there would be no net impact on the General Fund. There 
would be an increase in Federal Expenditure Funds allocations and revenue because the c. 20 reduction in MaineCare 
spending would be replaced with a reduction in state-only spending. 
LR2803(4) - Fiscal Note - Page 1 of 1