Resolve, To Reduce MaineCare Spending through Targeted Nutrition Interventions
Maine Legislature, Session 128, LD 1436
Committee Amendment CA_A_H508 (House)

COMMITTEE AMENDMENT" A" to H.P. 991, L.D. 1436, "Resolve, To Reduce 
MaineCare Spending through Targeted Nutrition Interventions'' 
Amend the resolve by striking out all of section 1 and insetting the following: 
'Sec. 1. Department of Health and Human Services to seek demonstration 
waiver. Resolved: That the Department of Health and Human Services shall file an 
application with the United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services to request a demonstration waiver under the federal 
Social Security Act, Section 1115 to develop a program to allow medically tailored food 
and nutrition interventions to be a reimbursable covered service. The program developed 
under the waiver is limited to patients being released from a hospital who have a high risk 
of readmission and have received a doctor's recommendation that certain elements of 
medically tailored food and nutrition interventions are necessary for the patient's health. 
Patients being offered medically tailored food and nutrition interventions may receive one 
meal per day for up to 7 days under the waiver program; and be it further 
Sec. 2. 
Department of Health and Human Services to reimburse for 
medical nutritional therapy. Resolved: That the Department of Health and Human 
Services shall provide for reimbursement under the MaineCare program on a pilot basis 
for 5 years for medical nutritional therapy to treat conditions that include, but are not 
limited to, being overweight, obesity, hypertension, diabetes, pre-diabetes, disorders of 
lipid metabolism, HIV infection, unintended weight loss in older adults, chronic kidney 
disease, gastrointestinal conditions, malnutrition and inappropriate eating habits. For the 
purposes of this section, "medical nutritional therapy" means a therapeutic approach to 
treatment of medical conditions and their associated symptoms by use of counseling and 
a specifically tailored diet devised and monitored by a physician licensed pursuant to the 
Maine Revised Statutes, Title 32, chapter 36 or 48 or a dietitian licensed pursuant to Title 
32, chapter 104 who practices in a hospital, outpatient setting or private office. Rules 
adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 
375, subchapter 2-A; and be it further' 
Page I - 128LR2099(02)-1 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT ·A "to H.P. 991, L.D. 1436 
Initiative: Provides appropriations and allocations for development and testing of changes 
to the Maine Integrated Health Management System claims processing system. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF (FORMERLY DHS) 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
DEPARTMENT TOTAL-ALL FUNDS 
2017-18 
$74,580 
$74,580 
2017-18 
$223,740 
$223,740 
2017-18 
$110,585 
$288,704 
$399,289 
2018-19 
$0 
$0 
2018-19 
$0 
$0 
2018-19 
$48,007 
$86,618 
$134,625 
Amend the resolve by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment, which is the majority report of the committee, narrows the 
medically tailored and nutrition interventions demonstration waiver program to 
individuals who are being released from the hospital, are at risk of readmission and have 
received a doctor's recommendation that certain elements of nutrition or foods are 
necessary for the patient's health. Patients offered medically tailored food and nutrition 
interventions may receive one meal per day for up to 7 days. The amendment also 
requires the Department of Health and Human Services to reimburse under the 
MaineCare program for medical nutritional therapy for certain conditions on a pilot basis. 
The Department of Health and Human Services must report annually for 5 years on the 
medically tailored food and nutritional interventions demonstration program and the 
medical nutritional therapy pilot program. 
The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 06/12/17 feac. 
LD 1436 
LR 2099(02) 
Resolve, To Reduce MaineCare Spending through Targeted Nutrition Interventions 
Fiscal Note for Bill as Amended by Committee Amendment,~,( H~So8) 
Committee: Health and Human Services 
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 2017-18 
$110,585 
$110,585 
$288,704 
$64,964 
FY 2018-19 
$48,007 
$48,007 
$86,618 
$86,618 
Projections 
FY 2019-20 
$48,007 
$48,007 
$86,618 
$86,618 
Projections 
FY 2020-21 
$48,007 
$48,007 
$86,618 
$86,618 
The bill includes General Fund appropriations to the Department of Health and Human Services of $110,5 85 in fiscal 
year 2017-18 and $48,007 in fiscal year 2018-19 for reimbursement of medically tailored food and nutrition 
interventions for certain inpatients at high risk of readmission and for a 5 year pilot program to reimburse medical. 
nutrition therapy to treat certain conditions and for development and testing of changes to the Maine Integrated Health 
Management System claims processing system. Federal Expenditures Fund allocations will also be required for the 
FMAPmatch. 
LR2099(02) - Fiscal Note - Page I of I