An Act To Clarify Medicaid Managed Care Ombudsman Services
Maine Legislature, Session 127, LD 1498
Committee Amendment CA_A_H620 (House)

COMMITTEE AMENDMENT "A" to H.P. 1021, L.D. 1498, Bill, "An Act To 
Clarify Medicaid Managed Care Ombudsman Services" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Clarify Medicaid Ombudsman Services' 
Amend the bill in section 1 in §3174-X in subsection 1 in paragraph A in the 2nd line 
(page 1, line 8 in L.D.) by inserting after the following: "Act." the following: "'Children's 
health insurance program" includes the Cub Care program, which is established in section 
4-T, the federal Children's Health Insurance Program, or CHIP, and the federal State 
Children's Health Insurance Program, or S-CHIP.' 
Amend the bill in section 1 in §3174-X in subsection 1 by striking out all of 
paragraph C (page 1, lines 11 to loin L.D.). 
Amend the bill in section 1 in §3174-X in subsection 1 in paragraph E in the 2nd line 
(page 1, line 20 in L.D.) by inserting after the following: "workshops" the following: 'for 
members, eligible members and health care providers, social service providers and health 
insurance navigators, brokers and agents' 
· . Amend the bill in section 1 in §3174-X in subsection 1 in paragraph E in toe last line 
(page 1, line 25 in L.D.) by inserting after the following: "programs" the following: 'such 
as, but not limited to, prescription assistance programs' 
Amend the bill in section 1 in §3174-X in subsection 1 by relettering the paragraphs 
to read alphabetically. 
Amend the bill in section 1 in §3174-X in subsection 2 in the 2nd line (page 1, line 28 
in L.D.) by striking out the following: "managed care" 
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Amend the bill in section 1 in §3174-X in subsection 2 in the 10th line (page 1, line 
in L.D.) by inserting after the following: "navigators" the following: ', brokers, agents' 
Amend the bill in section 1 in §3174-X in subsection 2 in the last line (page 1, line 38 
in L.D.) by inserting after the following: "program." the following: 'If members or 
eligible members described in this subsection are applying for or receiving long-term care 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. !021, L.D. 1498 
home-based and community-based services or institutional services, ombudsman 
assistance for those services is provided by the long-term care ombudsman program 
established pursuant to section 5106, subsection 11-C. The program shall coordinate with 
the long-term care ombudsman program on activities, including but not limited to 
marketing, outreach and referral services.' 
Amend the bill in section 1 in §3174-X in subsection 9 in the last line (page 3, line 16 
in L.D.) by inserting after the following: "subsection 3." the following: 'The program 
shall also report annually by January 1st to the joint standing committee of the 
Legislature having jurisdiction over health and human services matters on the activities 
and services of the program, priorities that may have been set by the program among 
types of inquiries and complaints, waiting lists for services and the provision of outreach 
services and recommendations for changes in statute, rules or policy to improve the 
provision of services.' 
Amend the bill in section 1 in §3174-X in subsection 10 in the 2nd and 3rd lines 
(page 3, lines 18 and 19 in L.D.) by striking out the following: 'for use as the state seed 
money for such a contract and General Fund money is not required' 
SUMMARY 
This amendment makes the following changes to the bill. 
1. It clarifies that the children's health insurance program is also known as Cubcare, 
CHIP and S-CHIP. 
2. It clarifies that the definition of "outreach and education" includes workshops for 
members, eligible members and health care providers, social service providers and health 
insurance navigators, brokers and agents and that screenings for eligibility include but are 
not limited to prescription assistance programs. 
3. It strikes references to managed care, including in the title of the bill. 
4. It clarifies that the long-term care ombudsman program established pursuant to the 
Maine Revised Statutes, Title 22, section 5106, subsection 11-C continues to provide 
services for those receiving long-term care home-based and community-based or 
institutional services. 
5. It requires the Medicaid ombudsman program to provide annual reports to the 
joint standing committee of the Legislature having jurisdiction over health and human 
services matters. 
6. It clarifies that the program may only be contracted for with nonstate funding and 
removes any references to state seed match. 
FISCAL NOTE REQUIRED 
(See attlCIKd) 
COMMITTEE AMENDMENT 
Revised: 03/25/16 Mac 
LD 1498 
LR2454(02) 
An Act To Clarify Medicaid Managed Care Ombudsman Services 
Fiscal Note for Bill as Amended by Committee Amendment '1\' L ~-~J..O) 
Committee: Health and Human Services 
Fiscal Note Required: Yes 
Fiscal Note 
Contigent current biennium cost increase - Other Special Revenue Funds 
Contigent current biennium revenue increase - Other Special Revenue Funds 
Contigent current biennium cost increase - Federal Expenditures Fund 
Contigent current biennium revenue increase - Federal Expenditures Fund 
Fiscal Detail and·Notes 
The bill requires the Department of Health and Human Services (DHHS) to contract for certain ombudsman services 
for the Medicaid program. The bill stipulates this will only occur if non-state funding is available. Currently, it is not 
anticipated that non-state funds would be made available now or in the near future. In addition, DHHS, in 
consultation with the Office of the Attorney General, has indicated that the non-state funds that were utilized in the 
past to obtain the federal medicaid grant funds for this contract are not suitable for consideration as matching funds. 
If the intent is to obtain federal dollars for this program the State will need to provide matching seed money. 
LR2454(02) - Fiscal Note - Page I of I