An Act To Assist Nursing Homes in the Management of Facility Beds
Maine Legislature, Session 129, LD 1577
Committee Amendment CA_A_H350 (House)

COMMITTEE AMENDMENT "A " to H.P. 1139, L.D. 1577, Bill, "An Act To 
Assist Nursing Homes in the Management of Facility Beds" 
Amend the bill by striking out all of sections 5 to 7 and inserting the following: 
'Sec. 5. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Nursing Facilities 0148 
Initiative: Provides appropriations and allocations for the Department of Health and 
Human Services to include in its calculation of reimbursement for services provided by a 
nursing facility the cost incurred by the facility for a medical director. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
OTHER SPECIAL REVENUE FUNDS 
All Other 
2019-20 
$181,495 
$181,495 
2019-20 
$386,809 
$386,809 
2019-20 
$36,275 
COMMITTEE AMENDMENT 
2020-21 
$244,008 
$244,008 
2020-21 
$513,731 
$513,731 
2020-21 
$48,366 
r~ 
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COMMITTEE AMENDMENT" A» to H.P. 1139, L.D. 1577 
OTHER SPECIAL REVENUE FUNDS TOTAL 
$36,275 
$48,366 
Nursing Facilities 0148 
Initiative: Provides appropriations and allocations for the Department of Health and 
Human Services to include the cost incurred by a nursing facility for the acquisition, use 
and maintenance of computer or cloud-based software systems as a fixed cost. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
HEALTH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
OTHER SPECIAL REVENUE FUNDS 
DEPARTMENT TOTAL-ALL FUNDS 
2019-20 
$399,757 
$399,757 
2019-20 
$851,980 
$851,980 
2019-20 
$79,898 
$79,898 
2019-20 
$581,252 
$1,238,789 
$116,173 
$1,936,214 
2020-21 
$537,448 
$537,448 
2020-21 
$1,131,534 
$1,131,534 
2020-21 
$106,531 
$106,531 
2020-21 
$781,456 
$1,645,265 
$154,897' 
$2,581,618 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment removes from the bill the sections related to bed hold days, health 
insurance and bad debt and adds an appropriations and allocations section. 
FISCAL NOTE REQUJRED 
(Soo Attached) 
COMMITTEE AMENDMENT 
Approved: 05/16/19 feaC!-
LD 1577 
LR 1116(02) 
An Act To Assist Nursing Homes in the Management of Facility Beds 
Fiscal Note for Bill as Amended by Committee Amendment ,A ( H,.. 3so) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Revenue 
Federal Expenditures Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY2019-20 
$581,252 
$581,252 
$1,238,789 
$116,173 
$1,238,789 
$115,173 
FY2020-21 
$781,456 
$781,456 
$1,645,265 
$154,897 
$1,645,265 
$154,897 
Projections 
FY2021-22 
$781,972 
$781,972 
$1,644,748 
$154,897 
$1,644,748 
$154,897 
Projections 
FY2022-23 
$781,972 
$781,972 
$1,644,748 
$154,897 
$1,644,748 
$154,897 
The bill includes General Fund appropriations to the Department of Health and Human Services of $581,252 in fiscal 
year 2019-20 and $781,456 in fiscal year 2020-21 for the Department of Health and Human Services to include in its 
calculation of reimbursement for services provided by a nursing facility the cost incurred by the facility for a medical 
director and to include the cost incurred by a nursing facility for the acquisition, use and maintenance of computer or 
cloud-based software systems as a fixed cost. Federal Expenditures Fund allocations are also included for the FMAP 
match and Other Special Revenue Funds allocations are included for the Service Provider Tax. 
The Upper Payment Limit (UPL) analysis for Nursing Facilities (NF) indicates that currently the NF payments in 
MaineCare are lower than Medicare by $12.5 million. The annual cost of living adjustments (COLA) for the NF's will 
go into effect on July 1, 2019 and are estimated to increase the payments by $10.6 million. The impact of this change 
on the UPL will be limited by an increase to the Medicare rates to which the MaineCare rates are compared, but 
between the COLA and the cost from this bill, the NF costs will likely go over the UPL threshold. However, based on 
the language in statute (Title 22 §1708 sub-§3, 1C) the DHHS must establish reimbursement rates that "are consistent 
with federal requirements relative to limits on reimbursement under the federal Social Security Act, Title XIX. 
Thus, 
the estimate of costs above includes all increases associated with the bill, with a federal match. If this does create a 
UPL issue, the DHHS will limit the payments to NF's to remain below the federally required limits. 
LRll 16(02) - Fiscal Note - Page 1 of 1