An Act To Amend O the Law Governing MaineCare Coverage of Chiropractic Treatment
Maine Legislature, Session 129, LD 0154
Committee Amendment CA_A_S37 (Senate)

COMMITTEE AMENDMENT "/J- "to S.P. 41, L.D. 154, Bill, "An Act To Amend 
O 
the Law Governing MaineCare Coverage of Chiropractic Treatment" 
Amend the bill by adding after section 2 the following: 
'Sec. 3. State plan amendment. No later than January 1, 2020, the Department 
of Health and Human Services shall apply to the United States Department of Health and 
Human Services, Centers for Medicare and Medicaid Services for a state plan amendment 
to allow for Medicaid reimbursement for all chiropractic services performed by 
chiropractic doctors licensed under the Maine Revised Statutes, Title 32, chapter 9 within 
their scope of practice. 
Sec. 4. Contingent effective date. That section of this Act that amends the 
Maine Revised Statutes, Title 22, section 3174-AAA, subsection 1 does not take effect 
unless: 
1. 
The United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services approves a state plan amendment to allow for Medicaid 
reimbursement for all chiropractic services performed by chiropractic doctors licensed 
under Title 32, chapter 9 within their scope of practice; and 
2. The Commissioner of Health and Human Services notifies the Secretary of State, 
the Secretary of the Senate, the Clerk of the House of Representatives and the Revisor of 
Statutes that written approval for the state plan amendment has been received. 
Sec. 5. Appropriations and allocations. The following appropriations and 
allocations are made. 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF 
Medical Care -Payments to Providers 0147 
Initiative: Provides funding to allow for all chiropractic services that are within the scope 
of practice of chiropractic doctors and performed by a licensed chiropractic doctor to be 
reimbursed under the MaineCare program. 
COMMITTEE AMENDMENT 
COMMITTEEAMENDMENT" ti "toS.P.41,L.D.154 (S-3'}) 
GENERAL FUND 
All Other 
GENERAL FUND TOTAL 
FEDERAL EXPENDITURES FUND 
All Other 
FEDERAL EXPENDITURES FUND TOTAL 
2019-20 
$128,684 
$128,684 
2019-20 
$226,796 
$226,796 
2020-21 
$257,367 
$257,367 
2020-21 
$453,592 
$453,592 
Amend the bill 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, requires the 
Department of Health and Human Services to apply for a state plan amendment to allow 
for Medicaid reimbursement for all chiropractic services within the scope of practice of 
chiropractic doctors no later than January 1, 2020. If the state plan amendment is not 
approved by the United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services, chiropractic doctors will not be reimbursed by 
MaineCare for any additional chiropractic services not currently eligible for 
reimbursement. The amendment also adds an appropriations and allocations section. 
FISCAL NOTE REQUJRED 
(See Attached) 
COMMITTEE AMENDMENT 
Approved: 03/26/19 feac:.. 
LD 154 
LR925(02) 
An Act To Amend the Law Governing MaineCare Coverage of Chiropractic Treatment 
Fiscal Note for Bill as Amended by Committee Amendment'~" (=:i ·31J 
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 
$128,684 
$128,684 
$226,796 
$226,796 
FY 2020-21 
$257,367 
$257,367 
$453,592 
$453,592 
Projections 
FY 2021-22 
$257,367 
$257,367 
$453,592 
$453,592 
Projections 
FY2022-23 
$257,367 
$257,367 
$453,592 
$453,592 
The bill includes General Fund appropriations to the Department of Health and Human Services of $128,684 in fiscal 
year 2019-20 and $257,367 in fiscal year 2020-21 to allow for all chiropractic services that are within the scope of 
practice of chiropractic doctors and performed by a licensed chiropractic doctor to be reimbursed under the 
MaineCare program. Federal Expenditures Fund allocations are also included for the FMAP match. 
There is a potential for savings which could mitigate the new costs above from individuals currently receiving 
services in a higher cost setting who may choose to receive services from a lower cost chiropractor and savings from 
individuals who choose the chiropractic setting initially for a new service. As it is not known how often this may 
occur no estimate of the potential savings is made at this time. 
LR0925(02) - Fiscal Note - Page 1 of 1