Resolve, Directing the Department of Health and Human Services To Amend Its Rules Governing Reimbursement to Hospitals for Patients Awaiting Placement in Nursing Facilities
Maine Legislature, Session 127, LD 1621
Committee Amendment CA_A_S433 (Senate)

COMMITTEE AMENDMENT ".A" to S.P. 659, L.D. 1621, "Resolve, Directing 
the Department of Health and Human Services To Amend Its Rules Governing 
Reimbursement to Hospitals for Patients Awaiting Placement in Nursing Facilities" 
Amend the resolve by striking out everything after the title and before the summary 
and inserting the following: 
'Sec. 1. Department of Health and Human Services; reimbursement for 
days awaiting placement; reimbursement for hospitals other than critical 
access hospitals. Resolved: That the Department of Health and Human Services shall 
amend the rules under Chapter 101: MaineCare Benefits Manual, Chapter III, Section 45, 
Hospital Services to provide reimbursement to hospitals other than critical access 
hospitals for each day after the 10th day that a MaineCare-eligible individual is in the 
care of a hospital while awaiting placement in a nursing facility. The Department of 
Health and Human Services shall reimburse hospitals prospectively at the statewide 
average rate per member day for nursing facility services. The Department of Health and 
Human Services shall compute the statewide average rate per member day based on the 
simple average of the nursing facility rate per member day for the applicable state fiscal 
year or years and prorated for the hospital's fiscal year. Reimbursement for days awaiting 
placement pursuant to this section is limited to a period of 5 years and to a maximum of 
$500,000 of combined General Fund funds and federal funds for each year of the 5-year 
period. Rules adopted pursuant to this section are routine technical rules as defined in the 
Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A; and be it further 
Sec. 2. Appropriations and allocations. Resolved: 
That the following 
appropriations and allocations are made. 
HEAL TH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY OHS) 
Medical Care - Payments to Providers 0147 
Initiative: Provides funding to hospitals other than critical access hospitals for 
MaineCare-eligible individuals in the care of hospitals while awaiting placement in 
nursing facilities. 
COMMITTEE AMENDMENT 
~c,i'":, 
COMMITIEEAMENDMENT" A"to S.P. 659,L.D.1621 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOT AL 
S~Y 
2015-16 
$0 
$0 
2015-16 
$0 
$0 
2016-17 
$23,772 
$23,772 
2016-17 
$42,169 
$42,169 
This amendment specifies that the reimbursement in the resolve for days awaiting 
placement does not begin until the 11th day that a MaineCare-eligible individual is in the 
care of a hospital while awaiting placement in a nursing facility. It also changes the 
maximum amount of funding to $500,000 in combined funding for each year; the resolve 
sets the maximum amount at $500,000 in combined funding over a 5-year period. It also 
adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
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Approved: 03/20/16 
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LD 1621 
LR 2706(02) 
Resolve, Directing the Department of Health and Human Services To Amend Its Rules Governing 
Reimbursement to Hospitals for Patients Awaiting Placement in Nursing Facilities 
Fiscal Note for Bill as Amended by Committee Amendment 'A'' Cs--trJ~\ 
Committee: Health and Human Services 
1) 
Net Cost (Savings) 
General Fund 
Appropriations/Allocations 
General Fund 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2015-16 
$0 
$0 
$0 
$0 
FY 2016-17 
$23,772 
$23,772 
$42,169 
$42,169 
Projections 
FY 2017-18 
$23,488 
$23,488 
$42,453 
$42,453 
Projections 
FY 2018-19 
$23,488 
$23,488 
$42,453 
$42,453 
The bill includes a General Fund appropriation to the Department of Health and Human Services of$23,772 in fiscal 
year 2016-17 to reimburse hospitals other than critical access hospitals for MaineCare eligible individuals in the care 
of hospitals while awaiting placement in nursing facilities. Federal Expenditures Fund allocations are also included 
for the FMAP match. 
LR2706(02) - Fiscal Note - Page 1 of 1