Resolve, To Address Reimbursement Rates for Licensed Clinical Social Workers under MaineCare
Maine Legislature, Session 129, LD 0692
Committee Amendment CA_A_H407 (House)

COMMITTEE AMENDMENT ·A" to H.P. 512, L.D. 692, "Resolve, To Address 
Reimbursement Rates for Licensed Clinical Social Workers under MaineCare" 
Amend the resolve by striking out everything after the title and inserting the 
following: 
'Sec. 1. 
Department of Health and Human Services to increase 
MaineCare rates. Resolved: That, no later than January 1, 2020, the Department of 
Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits 
Manual, Chapter III, Section 65 to increase reimbursement rates for counseling services 
provided by independent licensed clinical social workers as defined in the Maine Revised 
Statutes, Title 32, section 7001-A to no less than 70% of the Medicare rate for the closest 
equivalent service as long as the rate is no lower than the rate that exists on May 1, 2019. 
Rules adopted pursuant to this section are routine technical rules pursuant to Title 5, 
chapter 375, subchapter 2-A. 
Sec. 2. Appropriations and allocations. Resolved: 
That the following 
appropriations and allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Medical Care - Payments to Providers 0147 
Initiative: Provides appropriations for an increase to rates in rule Chapter 101: MaineCare 
Benefits Manual, Chapter III, Section 65, Behavioral Health Services to increase 
reimbursement rates for counseling services provided by independent licensed clinical 
social workers. 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
2019-20 
$284,870 
$284,870 
COMMITTEE AMENDMENT 
2020-21 
$569,740 
$569,740 
COMMITTEE AMENDMENT 'A" to H.P. 512, L.D. 692 
SUMMARY 
This amendment specifies that the services provided by independent licensed clinical 
social workers are provided under Section 65 of rule Chapter 101: MaineCare Benefits 
Manual, Chapter III. Rather than increasing rates to the lowest reimbursement rate for 
the same service paid by an insurance carrier licensed in Maine, the amendment increases 
rates to 70% of the Medicare rate for the closest equivalent service, since there is no exact 
equivalent rate under Medicare. 
The amendment also adds an appropriations ·and 
allocations section. 
FISCAL NOTE REQUIRED 
o 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 05/23/19 .feac.. 
LD 692 
LR999(02) 
Resolve, To Address Reimbursement Rates for Licensed Clinical Social Workers under MaineCare 
Fiscal Note for Bill as Amended by Committee Amendment'~' ( fj,,-q1J?) 
Committee: Health and Human Services 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2019-20 
FY 2020-21 
$284,870 
$569,740 
$284,870 
$569,740 
Projections 
FY2021-22 
$569,740 
$569,740 
Projections 
FY 2022-23 
$569,740 
$569,740 
The bill includes General Fund appropriations to the Department of Health and Human Services of $284,870 in fiscal 
year 2019-20 and $569,740 in fiscal year 2020-21 for an increase to rates in rnle Chapter 101: MaineCare Benefits 
Manual, Section 65 Behavioral Health Services, Chapter III to increase reimbursement rates for counseling services 
provided by independent licensed clinical social workers. 
PL 2017 c. 460 increased rates for services in Sections 17, 23 and 65 which are included in the Clinic Upper Payment 
Limit calculations. The impact of those increases put the department at or slightly above the amount allowed to be 
paid by the Centers for Medicare and Medicaid Services. As a result, the rate increase in this bill would have to be 
paid with state general fund money only. 
LR0999(02) - Fiscal Note - Page 1 of 1