An Act To Improve and Modernize Home-based Care
Maine Legislature, Session 129, LD 1655
Committee Amendment CA_A_H524 (House)

COMMITTEE AMENDMENT .. IJ" to H.P. 1191, L.D. 1655, Bill, "An Act To 
Improve and Modernize Home-based Care" 
Amend the bill by striking out all of section 1. 
Amend the bill in section 3 in paragraph E by striking out all of subparagraph (2) 
(page 1, lines 28 and 29 in L.D.) and inserting the following: 
'(2) Services of a phannacist licensed under Title 32. chapter 117 to provide 
medication evaluation or consultation to a member, including using telehealth 
services or by a home visit when technology is not the most effective mode of 
consultation.' 
Amend the bill in section 4 in paragraph C in the first line (page 2, line 1 in L.D.) by 
inserting after the following: "department on" the following: 'best practices and' 
Amend the bill by striking out all of sections 5 to 9 and inserting the following: 
'Sec. 5. Department of Health and Human Services to amend rules. The 
Department of Health and Human Services shall amend its rules for services provided 
under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Sections 19 
and 96 and rule Chapter 5, Office of Elder Services Policy Manual, Section 63 so that: 
1. A certified nurse practitioner licensed under the Maine Revised Statutes, Title 32, 
chapter 31 and a physician assistant licensed under Title 32, chapter 36 or 48 may 
authorize or amend a plan of care; 
2. Reimbursement is provided for activities performed outside of the home by a 
registered nurse licensed under Title 32, chapter 31 that are directly related to a member's 
care and are part of the member's plan of care; and 
3. Reimbursement is provided for a phannacist licensed under Title 32, chapter 117 
to provide medication evaluation or consultation to a member in a home visit when 
technology is not the most effective mode of consultation. 
COMMITTEE AMENDMENT 
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COMMITTEEAMENDMENT'/J"toH.P.1191,L.D. 1655 
Sec. 6. Department of Health and Human Services to amend rules. The 
Department of Health and Human Services shall amend its rules for services prqvided 
under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 40 so 
that: 
1. Reimbursement is provided for activities performed outside of the home by a 
registered nurse licensed under the Maine Revised Statutes, Title 32, chapter 31 that are 
directly related to a member's care and are part of the member's plan of care; and 
2. Reimbursement is provided for a pharmacist licensed under Title 32, chapter 117 
to provide medication evaluation or consultation to a member in a home visit when 
technology is not the most effective mode of consultation. 
Sec. 7. Federal regulations; rules. The Department of Health and Human 
Services shall amend its rules for services provided under rule Chapter 101: MaineCare 
Benefits Manual, Chapter II, Section 40 to allow a certified nurse practitioner licensed 
under the Maine Revised Statutes, Title 32, chapter 31 and a physician assistant licensed 
under Title 32, chapter 36 or 48 to authorize or amend a plan of care as soon as federal 
regulations allowing it are promulgated.' 
Amend the bill by adding after section 10 the following: 
'Sec. 11. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Medical Care-Payments to Providers 0147 
Initiative: Provides appropriations and allocations for the Department of Health and 
Human Services to amend the rules for services under rule Chapter 101: MaineCare 
Benefits Manual, Chapters II and III, Sections 19 and 96 and rule Chapter 5, Office of 
Elder Services Policy Manual, Section 63 so that reimbursement is provided for activities 
performed outside of the home by a registered nurse that are directly related to a 
member's care and are part of the member's plan of care. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2019-20 
$425,289 
$425,289 
2019-20 
$755,414 
$755,414 
2020-21 
$428,211 
$428,211 
2020-21 
$752,491 
$752,491 
Office of MaineCare Services 0129 
Initiative: Provides one-time appropriations and allocations for required technology 
changes. 
COMMITTEE AMENDMENT 
,1-,. ., 
COMMITTEE AMENDMENT..;/,, to H.P. 1191, L.D. 1655 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
HEAL TH AND HUMAN SERVICES, 
DEPARTMENT OF 
DEPARTMENT TOTALS 
GENERAL FUND 
FEDERAL EXPENDITURES FUND 
DEPARTMENT TOTAL-ALL FUNDS 
2019-20 
$74,603 
$74,603 
2019-20 
$223,809 
$223,809 
2019-20 
$499,892 
$979,223 
$1,479,115 
2020-21 
$0 
$0 
2020-21 
$0 
$0 
2020-21 
$428,211 
$752,491 
$1,180,702 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section munber to read consecutively. 
SUMMARY 
This amendment removes the sections of the bill that establish the Social 
Determinants of Health Stakeholder Advisory Group within the Department of Health 
and Human Services, requires review of certain home-based and community-based 
MaineCare reimbursement rates every 2 years and convenes a work group to review 
options for adjusting reimbursement rates for home-based and community-based services. 
It requires the department to amend its rules for reimbursement for pharmacists 
conducting a medication evaluation or consultation in the home. It clarifies that certified 
nurse practitioners and physician assistants may only authorize or amend a plan of care 
under rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 40 after the 
Federal Government allows for it. It adds making recommendations to the department on 
best practices to the additional duties of the Maine Telehealth and Telemonitoring 
Advisory Group included in the bill. It also adds an appropriations and allocations 
section. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/23/19 feac. 
LD 1655 
LR 1678(02) 
An Act To Improve and Modernize Home-based Care 
Fiscal Note for Bill as Amended by Committee Amendment,,/)( /1-s~y) 
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 2019-20 
FY 2020-21 
$499,892 
$499,892 
$979,223 
$979,223 
$428,211 
$428,211 
$752,491 
$752,491 
Projections 
FY2021-22 
$428,477 
$428,477 
$752,226 
$752,226 
Projections 
FY 2022-23 
$428,477 
$428,477 
$752,226 
$752,226 
The bill includes General Fund appropriations to the Department of Health and Human Services of $499,892 in fiscal 
year 2019-20 and $428,211 in fiscal year 2020-21 to allow that reimbursement is provided for activitiesperformed 
outside of the home by a registered nurse that are directly related to a member's care and are part of the member's plan 
of care and for required technology changes. Federal Expenditures Fund allocations are also included for the FMAP 
match. 
LR1678(02) - Fiscal Note - Page 1 of 1