An Act Concerning MaineCare Coverage for Donor Breast Milk
Maine Legislature, Session 130, LD 0085
Committee Amendment CA_A_SA_A_S585 (Senate)
Amends: 22 MRSA §3174

SENATE AMENDMENT" A "to COMMITTEE AMENDMENT "A" to H.P. 51, 
L.D. 85, "An Act Concerning MaineCare Coverage for Donor Breast Milk" 
Amend the amendment by striking out everything after the title and inserting the 
following: 
'Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 22 MRSA §3174-111 is enacted to read: 
§3174-ill. Reimbursement for donor breast milk 
1. 
Reimbursement. 
The department shall provide reimbursement under the 
MaineCare program for pasteurized donor breast milk provided to an infant receiving 
benefits under this chapter if a physician or physician assistant licensed under Title 32, 
chapter 36 or 48 or an advanced practice registered nurse licensed under Title 32, chapter 
signs an order stating that: 
A. The infant is medically or physically unable to receive maternal breast milk or 
participate in breastfeeding or the infant's mother is medically or physically unable to 
produce maternal breast milk in quantities sufficient for the infant; and 
B. The infant: 
(1) Was born at a birth weight of less than 1,500 grams; 
(2) 
Has a gastrointestinal anomaly or metabolic or digestive disorder or is 
recovering from intestinal surgery and the infant's digestive needs require 
additional support; 
(3) Is not appropriately gaining weight or growing; 
(4) Has formula intolerance and is experiencing weight loss or difficulty feeding; 
(5) Has low blood sugar; 
(6) Has congenital heart disease; 
(7) Has received or will receive an organ transplant; or 
(8) Has another serious medical condition for which donor breast milk is medically 
necessary. 
SENATE AMENDMENT 
~os 
SENATE AMENDMENT" ft "to COMMITTEEAMENDMENT"A" to H.P. 51, L.D. 85 {5-5'6'5) 
2. Rulemaking. The department shall adopt rules to implement this section. Rules 
adopted pursuant to this subsection are routine technical rules as defined by Title 5, chapter 
375, subchapter 2-A. 
Sec. 2. Medicaid state plan amendment or waiver. The Department of Health 
and Human Services shall prepare and submit a Medicaid state plan amendment or waiver 
as necessary to the United States Department of Health and Human Services, Centers for 
Medicare and Medicaid Services no later than January 1, 2023 that provides or requests, as 
appropriate, Medicaid coverage consistent with this Act for donor breast milk for infants. 
Sec. 3. 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 to the Department of Health and Human 
Services to provide reimbursement under the MaineCare program for pasteurized donor 
breast milk provided to an infant if a physician, physician assistant or advanced practice 
registered nurse signs an order stating that such milk is necessary. 
GENERAL FUND 
2021-22 
2022-23 
All Other 
$0 
$157,872 
GENERAL FUND TOTAL 
$0 
$157,872 
FEDERAL EXPENDITURES FUND 
2021-22 
2022-23 
All Other 
$0 
$279,690 
FEDERAL EXPENDITURES FUND TOTAL 
$0 
$279,690 
Amend the amendment by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment incorporates the substance of Committee Amendment "A" to avoid a 
statutory allocation conflict but changes the date by which the Department of Health and 
Human Services must prepare and submit a Medicaid state plan amendment or waiver to 
the United States Department of Health and Human Services, Centers for Medicare and 
Medicaid Services to January I, 2023. It also strikes and replaces the appropriations and 
allocations section. ~-------
SPONSORED BY:-~-----......:....----------
(Senator BREEN, C.) 
COUNTY: Cumberland 
FISCAL NOTE REQUIRED • · 
(See attached) 
SENATE AMENDMENT 
( 
Approved: 04/21/22 :tPae. 
LD85 
LR 662(04) 
An Act Concerning MaineCare Coverage for Donor Breast Milk 
Fiscal Note for Senate Amendment"#' to Committee Amendment "A" (S-S t0 
Sponsor: Sen. Breen of Cumberland 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2021-22 
FY 2022-23 
Projections 
FY 2023-24 
Projections 
FY 2024-25 
Net Cost (Savings) 
General Fund 
\.ppropriations/ Allocations 
General Fund 
Federal Expenditures Fund 
Revenue 
Federal Expenditures Fund 
Fiscal Detail and Notes 
($157,872) 
($157,872) 
($279,690) 
($279,690) 
$350 
$350 
($350) 
($350) 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
$0 
This amendment changes the General Fund appropriations to the Department of Health and Human Services from 
$157,872 in fiscal year 2021-22 and $157,522 in fiscal year 2022-23 to $0 in fiscal year 2021-22 and $157,872 in 
fiscal year 2022-23 due to a change in the effective date. Federal Expenditures Fund allocations are adjusted for the 
new effective date. 
LR0662(04) - Fiscal Note - Page 1 of 1