An Act To Restore Eligibility and Funding for Drug Programs for the Elderly and Disabled
Maine Legislature, Session 126, LD 0629
Committee: Health and Human Services
Sponsors: TUTTLE, FARNSWORTH, CAIN, CRAVEN, GOODALL, GRATWICK, HASKELL, HILL, JOHNSON, LACHOWICZ
Amends: 22 MRSA §254-D

Legislative Document 
No. 629 
S.P. 219 
In Senate, February 21, 2013 
An Act To Restore Eligibility and Funding for Drug Programs for 
the Elderly and Disabled 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
DAREK M. GRANT 
Secretary of the Senate 
Presented by Senator TUTTLE of York. 
Cosponsored by Representative FARNSWORTH of Portland and 
Senators: CAIN of Penobscot, CRAVEN of Androscoggin, GOODALL of Sagadahoc, 
GRATWICK of Penobscot, HASKELL of Cumberland, HILL of York, JOHNSON of Lincoln, 
LACHOWICZ of Kennebec. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §254-D, sub-§4, ¶D, as amended by PL 2011, c. 657, Pt. HH, 
§1, is further amended to read: 
D.    Income eligibility of individuals must be determined by this paragraph and by 
reference to the federal poverty guidelines for the 48 contiguous states and the 
District of Columbia, as defined by the federal Office of Management and Budget 
and revised annually in accordance with the United States Omnibus Budget 
Reconciliation Act of 1981, Section 673, Subsection 2, Public Law 97-35, 
reauthorized by Public Law 105-285, Section 201 (1998).  If the household income is 
not more than 175% 185% of the federal poverty guideline applicable to the 
household, the individual is eligible for the basic program and the supplemental 
program.  Individuals are also eligible for the basic and the supplemental program if 
the household spends at least 40% of its income on unreimbursed direct medical 
expenses for prescription drugs and medications and the household income is not 
more than 25% higher than the levels specified in this paragraph.  For the purposes of 
this paragraph, the cost of drugs provided to a household under this section is 
considered a cost incurred by the household for eligibility determination purposes. 
Sec. 2.  Medicaid state plan amendment for the Medicare savings 
program.  Notwithstanding Public Law 2011, chapter 657, Part HH, section 2, the 
Department of Health and Human Services shall prepare and submit a Medicaid state 
plan amendment to the federal Centers for Medicare and Medicaid Services that, effective 
October 1, 2013, effectively increases income eligibility levels for the Medicare savings 
program as follows: for the Qualified Medicare Beneficiary program, to income not more 
than 150% of the federal poverty level; for the Specified Low-Income Medicare 
Beneficiary program, to income more than 150% but not more than 170% of the federal 
poverty level; and for the Qualified Individuals program, to income more than 170% but 
not more than 185% of the federal poverty level. 
Sec. 3.  Appropriations and allocations.  The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS) 
FHM - Drugs for the Elderly and Disabled Z015 
Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings 
program. 
FHM - Medical Care 0960 
FUND FOR A HEALTHY MAINE 
2013-14
2014-15
All Other 
$1,219,908
$1,626,544
FUND FOR A HEALTHY MAINE TOTAL 
$1,219,908
$1,626,544
Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings 
program. 
Low-cost Drugs To Maine's Elderly 0202 
Initiative: Provides funding to restore the upper income eligibility level for the Low-cost 
Drugs to Maine's Elderly program from 175% to 185% of the federal poverty level. 
Medical Care - Payments to Providers 0147 
Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings 
program. 
Medical Care - Payments to Providers 0147 
Initiative: Restores funding for MaineCare hospital crossover payments as a result of 
restoring income eligibility levels for the Medicare savings program. 
FUND FOR A HEALTHY MAINE 
2013-14
2014-15
All Other 
($1,219,908)
($1,626,544)
FUND FOR A HEALTHY MAINE TOTAL 
($1,219,908)
($1,626,544)
GENERAL FUND 
2013-14
2014-15
All Other 
$112,154
$149,538
GENERAL FUND TOTAL 
$112,154
$149,538
GENERAL FUND 
2013-14
2014-15
All Other 
$1,219,908
$1,626,544
GENERAL FUND TOTAL 
$1,219,908
$1,626,544
GENERAL FUND 
2013-14
2014-15
All Other 
$1,663,554
$2,218,072
GENERAL FUND TOTAL 
$1,663,554
$2,218,072
FEDERAL EXPENDITURES FUND 
2013-14
2014-15
All Other 
$2,865,588
$3,820,785
FEDERAL EXPENDITURES FUND TOTAL 
$2,865,588
$3,820,785
Sec. 4.  Contingent effective date.  Section 2 of this Act takes effect only if: 
1. The Commissioner of Health and Human Services receives written approval of the 
application for an increase in income eligibility levels as described in section 2 from the 
federal Centers for Medicare and Medicaid Services or the commissioner receives written 
notification from the Centers for Medicare and Medicaid Services that such approval is 
not necessary; and  
2. The Commissioner of Health and Human Services notifies the Secretary of State, 
the Secretary of the Senate, the Clerk of the House of Representatives and the Revisor of 
Statutes that written approval of the application or written notification that such approval 
is not necessary has been received. 
SUMMARY 
In Public Law 2011, chapter 657, Part HH, the Commissioner of Health and Human 
Services was directed to seek a waiver to reduce income eligibility levels for the 
Medicare savings program by 10%.  The reduction of income eligibility levels was 
contingent on the grant of the waiver by the federal Centers for Medicare and Medicaid 
Services; the waiver was granted. 
This bill instructs the Commissioner of Health and Human Services to submit an 
application to restore income eligibility levels for the Medicare savings program to the 
levels they were before the waiver was granted and makes the increase contingent upon 
the approval of the federal Centers for Medicare and Medicaid Services. This bill also 
makes adjustments to appropriations and allocations to reflect the increase in the 
eligibility levels. 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
2013-14
2014-15
GENERAL FUND 
$2,995,616
$3,994,154
FEDERAL EXPENDITURES FUND 
$2,865,588
$3,820,785
FUND FOR A HEALTHY MAINE 
$0
$0
DEPARTMENT TOTAL - ALL FUNDS 
$5,861,204
$7,814,939