An Act To Limit Payment for Care and Treatment of Residents of State Institutions
Maine Legislature, Session 125, LD 1628
Committee Amendment CA_B_S469 (Senate)

COMMITTEE AMENDMENT" l3" to S.P. 538, L.D. 1628, Bill, "An Act To Limit 
Payment for Care and Treatment of Residents of State Institutions" 
Amend the bill by striking out all of section 5 and inserting the following: 
'Sec. 5. 34-B MRS A §1409, sub-§l1, ,C is enacted to read: 
C. 
For a resident receiving services, including medical care, goods, prescription 
drugs and other medications, outside a state institution, the commissioner may pay 
the provider of those services an amount no greater than the following: 
(1) For residents that have insurance, the amount that would be payable pursuant 
to any insurance benefit, including Medicare, that the resident is eligible to 
receIve; 
(2) For physicians and hospitals that are not designated critical access hospitals, 
the reimbursement rate applicable to that provider and that service, as established 
by rule by the department for the MaineCare program under Title 22, divided by 
75%; or 
(3) For all other providers, the reimbursement rate applicable to that provider 
and that service, as established by rule by the department for the MaineCare 
program under Title 22.' 
Amend the bill by adding after section 6 the following: 
'Sec. 7. Appropriations and allocations. 
The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) 
Disproportionate Share - Dorothea Dix Psychiatric Center 0734 
Initiative: Reduces funding from savings from limiting reimbursement for medical 
services provided to a resident of a state institution outside of a state institution. 
COMMITTEE AMENDMENT 
~ 0:.. 
'\;,''''' 
COMMITTEE AME1\TDMENT" e" to S.P. 538, L.D. 1628 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Disproportionate Share - Riverview Psychiatric Center 0733 
2011-12 
$0 
$0 
2012-13 
($4,786) 
($4,786) 
Initiative: Reduces funding from savings from limiting reimbursement for medical 
services provided to a resident of a state institution outside of a state institution. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
Dorothea Dix Psychiatric Center 0120 
2011-12 
$0 
$0 
2012-13 
($41,318) 
($41,318) 
Initiative: Reduces funding from savings from limiting reimbursement for medical 
services provided to a resident of a state institution outside of a state institution. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Riverview Psychiatric Center 0105 
2011-12 
$0 
$0 
2011-12 
$0 
$0 
Initiative: Reduces funding from savings from limiting reimbursement for 
services provided to a resident of a state institution outside of a state institution. 
GENERAL FUND 
2011-12 
All Other 
$0 
GENERAL FUND TOTAL 
$0 
COMMITTEE AMENDMENT 
2012-13 
($2,525) 
($2,525) 
2012-13 
($9,691) 
($9,691) 
medical 
2012-13 
($8,492) 
($8,492) 
COMMITTEE AMENDMENT" 2»" to S.P. 538, L.D. 1628 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY BDS) 
DEPARTMENT TOTALS 
GENERAL FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
SUMMARY 
2011-12 
$0 
$0 
2011-12 
$0 
$0 
$0 
2012-13 
($78,190) 
($78,190) 
2012-13 
($57,121) 
($87,881) 
($145,002) 
This amendment, which is the minority report of the committee, limits the amount 
that the Commissioner of Health and Human Services may pay a provider for medical 
services provided to a resident of a state institution off the premises of the state institution 
to the amount payable under insurance, including Medicare, for residents that have 
insurance; to the amount established by rule by the Department of Health and Human 
Services under the MaineCare program, divided by 75% for physicians and hospitals 
other than critical access hospitals; or to the MaineCare rate for all other providers. It 
also adds an appropriations and allocations section to the bill. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/09112 
~.:zc. 
LD 1628 
LR 2492(03) 
An Act To Limit Payment for Care and Treatment of Residents of State Institutions 
Fiscal Note for Bill as Amended by Committee Amendment "13" S - ~9 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2011-12 
FY 2012-13 
Projections 
FY 2013-14 
Projections 
FY 2014-15 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Other Special Revenue Funds 
Revenue 
Other Special Revenue Funds 
Fiscal Detail and Notes 
$0 
$0 
$0 
$0 
($57,121) 
($57,121) 
($87,881) 
($87,881) 
($57,121) 
($57,121) 
($87,881) 
($87,881) 
($57,121) 
($57,121) 
($87,881) 
($87,881) 
The General Fund savings associated with limiting reimbursement for medical services provided to a resident of a 
state institution outside of the state institution is estimated to be $57,121 in fiscal year 2012-13. The Other Special 
Revenue Funds savings and corresponding reduction in revenue is estimated to be $87,881 in fiscal year 2012-13. 
LR2492(03) - Fiscal Note - Page 1 of 1