An Act To Provide Maine Children Access to Affordable Health Care
Maine Legislature, Session 130, LD 0372
Committee Amendment CA_C_SA_A_S591 (Senate)

SENATE AMENDMENT" A" to COMMITTEE AMENDMENT "C" to S.P. 158, 
L.D. 372, "An Act To Provide Maine Children Access to Affordable Health Care" 
Amend the amendment by inserting after the title the following: 
'Amend the bill by striking out the title and substituting the following: 
'An Act To Establish the Hospital System Loan Fund Program'' 
Amend the amendment by striking out everything after the title and inserting the 
following: 
'Amend the bill by inserting after the title and before the enacting clause the following: 
'Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, this legislation needs to take effect before the expiration of the 90-day 
period in order to provide financial assistance to hospitals as soon as possible so that they 
may continue to provide vital services to the residents of this State; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore,' 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. Hospital System Loan Fund Program. Notwithstanding any provision 
of law to the contrary, the Hospital System Loan Fund Program, referred to in this section 
as "the program," is established within the Finance Authority of Maine, referred to in this 
section as "the authority," for the purpose of alleviating hardship on hospitals as a result of 
loan payments due as a result of the Medicare accelerated payment program in 42 United 
States Code, Section 1395g(f)(2)(C). For an applicant to participate in the program, the 
applicant must demonstrate to the satisfaction of the authority that the applicant faces a 
repayment to the Medicare program in 2022 pursuant to the Medicare accelerated payment 
program of more than $12 million and less than $18 million as of June 1, 2022; faces 
repayment obligations that would otherwise constitute a hardship to the hospital pursuant 
SENATE AMENDMENT 
ROS 
SENATE AMENDMENT"~ "to COMMITTEE AMENDMENT "C" to S.P. 158, L.D. 372 Cs· sci\) 
to 42 United States Code, Section 1395ddd(f)(I); and has less than 60 days' cash on hand 
as of May 1, 2022. 
1. Hospital System Loan Fund. The Hospital System Loan Fund, referred to in this 
section as "the fund," is created as a nonlapsing, interest-earning, revolving fund to carry 
out the purposes of this section. 
A. The authority may receive, invest and expend on behalf of the fund money from 
gifts, grants, bequests, loans and donations in addition to money appropriated or 
allocated by the State. Money received by the authority on behalf of the fund must be 
used for the purposes of this section. The fund must be maintained and administered 
by the authority. 
B. Applications to participate in the program must be made available by the authority 
no later than June 1, 2022 and decisions must be made no later than July 1, 2022 and 
any loans must be issued by the authority by August 1, 2022. 
C. The total amount of funding to be distributed by the authority from the fund may 
not exceed $12 million. Multiple loan applications must result in a proration of funds. 
D. The repayment term for a borrower is 24 months and the interest rate is zero. The 
loan must be repaid by a bonower in equal monthly installments beginning one month 
after receipt of funds. 
There is no penalty for early repayments. Any amounts 
remaining unpaid after 24 months must be recovered as a reduction to the first 
supplemental pool payment to the loan recipient made pursuant to rule Chapter 101: 
MaineCare Benefits Manual, Chapter III, Section 45 .04 following the end of the 24-
month repayment period. 
E. A bonower receiving a loan shall participate in the Medicaid program during the 
term of the loan. Any unpaid amount of the loan must be repayable by the borrower 
within 30 days of the bonower no longer being a Medicaid provider. The authority 
shall notify the Department of Health and Human Services of the loan recipients. The 
department shall notify the authority if during the term of the loan a bonower receiving 
the loan no longer participates in the Medicaid program. 
F. Beginning August 1, 2024 and quarterly thereafter, the authority shall transfer the 
repaid principal balance to the Reserve for FAME Hospital - Hospital System Loans 
General Fund account established in section 2. 
G. Costs and expenses incurred by the authority, including but not limited to 
maintaining, servicing and administering the fund, may be paid out of the fund. 
2. Administration; rules. The program and the fund are administered by the 
authority. The authority may adopt rules to carry out the purposes of this section. Rules 
adopted pursuant to this subsection are routine technical rules pursuant to the Maine 
Revised Statutes, Title 5, chapter 375, subchapter 2-A. 
3. Report. The authority shall report to the State Controller on loan disbursements 
and loan repayments annually, beginning on July 1, 2023, and upon the transfer of funds. 
Sec. 2. Reserve for FAME Hospital - Hospital System Loans account 
established. Notwithstanding any provision of law to the contrary, the State Controller 
shall establish the Reserve for FAME Hospital - Hospital System Loans General Fund 
account. 
SENATE AMENDMENT 
ROS 
SENATE AMENDMENT" f\- "to COMMITTEE AMENDMENT "C" to S.P. 158, L.D. 372 ( Sr 'S'1') 
Sec. 3. Transfer from MaineCare Stabilization Fund. Notwithstanding any 
provision of law to the contrary, at the close of fiscal year 2021-22, the State Controller 
shall transfer $12 million from the available balance in the MaineCare Stabilization Fund 
Other Special Revenue Funds account within the Department of Health and Human 
Services to the General Fund unappropriated surplus. 
Sec. 4. Transfer from General Fund unappropriated surplus; FAME 
Hospital - Hospital System Loan Fund account. Notwithstanding any provision of 
law to the contrary, at the close of fiscal year 2021-22, the State Controller shall transfer 
$12 million from the unappropriated surplus of the General Fund to the Finance Authority 
of Maine's FAME Hospital - Hospital System Loan Fund Other Special Revenue Funds 
account. 
Sec. 5. Transfer from Reserve for FAME Hospital - Hospital System Loans 
account; MaineCare Stabilization Fund. Notwithstanding any provision of law to 
the contrary, at the close of fiscal year 2024-25, the State Controller shall transfer the 
balance in the Reserve for FAME Hospital - Hospital System Loans General Fund account 
to the MaineCare Stabilization Fund Other Special Revenue Funds account within the 
Department of Health and Human Services. 
Sec. 6. 
Appropriations and allocations. The following appropriations and 
allocations are made. 
FINANCE AUTHORITY OF MAINE 
Hospital - Hospital System Loans Fund N962 
Initiative: Provides one-time allocation for the Hospital - Hospital System Loans Fund 
program. 
OTHER SPECIAL REVENUE FUNDS 
All Other 
OTHER SPECIAL REVENUE FUNDS TOTAL 
Amend the bill by adding before the summary the following: 
2021-22 
$0 
$0 
2022-23 
$12,000,000 
$12,000,000 
'Emergency clause. In view of the emergency cited in the preamble, this legislation 
takes effect when approved.'' 
Amend the amendment by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment establishes the Hospital System Loan Fund Program within the 
Finance Authority of Maine. The program is established to alleviate the hardship of 
hospitals resulting from loan payments through the Medicare accelerated payment 
program. The amendment also transfers $12 million from the MaineCare Stabilization 
Fund to the unappropriated surplus of the General Fund and transfers $12 million from the 
unappropriated surplus of the General Fund to the Finance Authority of Maine's FAME 
Hospital - Hospital System Loan Fund Other Special Revenue Funds account. Beginning 
SENATE AMENDMENT 
ROS 
SENATE AMENDMENT" A "to COMMITTEE AMENDMENT "C" to S.P. 158, L.D. 372 ( ~-5 9 0 
August 1, 2024, the Finance Authority of Maine must transfer quarterly the repaid principal 
balance to the Reserve for FAME Hospital -
spit System Loans General Fund account. 
SPONSORED BY: -1-----,.:'-"'---,l-..:.=-....:......j..,1-------
(Senator BREEN, C.) 
COUNTY: Cumberland 
FISCAL NOTE REQUIRED 
(See attached) 
SENATE AMENDMENT 
( 
Approved: 04/21/22 feae 
LD372 
LR 876(09) 
An Act To Provide Maine Children Access to Affordable Health Care 
Fiscal Note for Senate Amendment "A" to Committee Amendment "C" {~S'ii) 
Sponsor: Sen. Breen of Cumberland 
Net Cost (Savings) 
General Fund 
Appropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Other Special Revenue Funds 
Federal Block Grant Fund 
Revenue 
Federal Expenditures Fund 
Federal Block Grant Fund 
Transfers 
General Fund 
Other Special Revenue Funds 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2021-22 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
FY 2022-23 
($3,256,625) 
($3,256,625) 
($386,079) 
$11,946,265 
($9,008,716) 
Projections 
FY 2023-24 
($6,229,892) 
($6,229,892) 
$0 
$0 
($18,017,432) 
Projections 
FY 2024-25 
($6,229,892) 
($6,229,892) 
$0 
$0 
($18,017,432) 
($386,079) 
$0 
$0 
($9,008,716) 
($18,017,432) 
($18,017,432) 
$0 
$0 
$0 
$0 
$0 
$0 
This amendment strikes the entire bill and replaces with new language. The amendment includes a one-time Other 
Special Revenue Funds allocation to the Finance Authority of Maine of $12,000,000 in fiscal year 2022-23 for the 
Hospital - Hospital System Loans Fund. It also includes a transfer of $12,000,000, by June 30th, 2022, froni the 
MaineCare Stabilization Fund to the unappropriated surplus of the general fund and a transfer of $12,000,000, by June 
30th 2022, from the unappropriated surplus of the General Fund to the Hospital - Hospital System Loans Fund. 
LR0876(09) - Fiscal Note - Page 1 of 1