An Act Making Supplemental Appropriations and Allocations from the
Maine Legislature, Session 132, LD 2212
Committee Amendment CA_A_SA_C_S650 (Senate)
Amends: 22 MRSA §3198

SENATE AMBNDMENT "(^ " to COMMITTEE AMENDMENT "A" to H.P. 1491,
L.D. 2212, "An Act Making Supplemental Appropriations and Allocations from the
General Fund and Other Funds for the Expenditures of State Government and Changing
Certain Provisions of the Law Necessary to the Proper Operations of State Government for
the Fiscal Years Ending June 30,2026 and June 30,2027"
Amend the amendment by inserting after Part HHHH the following:
'PART im
Sec.IIII-1. 22 MRSA §3198 is enacted to read:
§3198. Able-bodied, childless adults; temporary enrollment freeze; permanent
enrollment cap
Notwithstanding any provision of law to the contrary, the followine provisions aDplv
to Medicaid enrolhnent levels for enrollees who are classified as able-bodied. childless
adults.
1. Temoorarv enrollment freeze. Contiiment on aom'oval of a Section 1115
demonstration waiver under the United States Social Security Act from the United States
Department of Health and Human Services. Centers for Medicare and Medicaid Services.
withm 30 days of the effective date of this section, the total number ofMaiaeCare enrollees
25' classified as able-bodiecL childless adu^^^^ may be enrolled in the MaineCare proeram
must be firozen and the enrollment level may not be increased. New enrollments of able-
bodied. childlessaduU^^^^ until the department has certified that the total
enrollment in this category has been reduced by 10% from the level of enrollment at the
date enrollment is frozen under this subsection.
2._JEnrollment reduction. When an enrollee becomes inelieible for MaineCare
coverage, that enrollee may not be automatically reenrolled, When an enrollee's elieibilitv
lapses due to income increase, employment or failure to renew enrollment, that enrollees
scot in the oroeram mavjiQt_beJUled by a new enrollee. The department shall oriontize
proeram integrity measures to remove ineligible enrollees.
3. Liftine enrollment freeze; Dermanent enrollment cap. When the total enrollment
ofable-bodied. childless adults has declined by 10% from the number of enrollments at the
time of the enrollment freeze pursuant to subsection 1. the reduced level of enrolknent is
SENATE AMENDMENT
SENATE AMENDMENT "(^" to COMMITTEE AMENDMENT "A" (o H.P. 1491, L.D. 2212 (^ "*
established as a new permanent cap on the level of enrollment for abte-bodied. childless
adults. The enrollment cap established pursuant to this section may not be exceeded unless
the Legislature soecificallv authorizes it.
4. Leeislative oversieht; quarterly nroeress reports: additional proeram inteeritv
measures. Beainnine 3 months after the effective date of this section. the department shall
submit quarterly reports to the Legislature detailine the department's efforts to reduce the
enrollment levels of able-bodied. childless adults under subsection 2. If the Leeislature
determines that the department has failed to make meaningful progress. the Leeislature
may impose additional program integrity measures to ensure compliance.
Sec. HII-2. MaineCare enrollment freeze; Department of Health and
Human Services to request waiver. No later than October 1,2026, the Department of
Health and Hmnan Services shall request federal approval from the United States
Department of Health and Human Services, Centers for Medicare and Medicaid Services
for a Section 1 115 demonstration waiver under the United States Social Security Act that
would temporarily freeze MaineCare enrollment for able-bodied, childless adults, reduce
enrollment in that category over time and create a permanent enrollment cap at the reduced
enrollment level after the freeze is lifted. If the waiver is approved, the department shall
adopt rules to implement the enrollment freeze no later than 90 days after approval. Rules
adopted pursuant to this section are routine technical rules as defined in the Maine Revised
Statutes, Title 5, chapter 375, subchapter 2-A.
Sec.IIII-3. MaineCare program review. The Department of Health and Human
Services shall engage a 3rd-party independent entity, referred to in this section as "the
independent entity," to conduct a review of the MaineCare program for fraud, waste and
abuse pursuant to this section.
1. Selection of independent entity. Within 30 days of the effective date of this Part,
the department shall issue a request for proposals to determine, through a competitive
bidding process, the independent entity to conduct the review required by this section.
2. Duties of independent entity. The independent entity chosen shall:
A. Review and assess current processes, procedures and capacity in place to identify
fraud, waste and abuse, including but not limited to the department's Fraud
Investigation and Recovery Unit, the MaineCare program integrity unit, the Medicaid
Eligibility Quality Control program and the efficacy of the State's implementation of
the payment error rate measurement process;
B. Identify best practices in state fraud, waste and abuse prevention, identification and
resolution;
C. Use any available prior state and federal audits, reviews, investigations, reports,
data and information, including but not limited to audit findings, claims data, provider
records, program integrity reports, United States Department of Health and Human
Services, Centers for Medicare and Medicaid Services' communications and
whistleblower complaints, to identify systemic vulnerabilities, patterns of fraud, waste
and abuse and gaps in oversight; and
D. Make recommendations to strengthen the State's practices for preventing,
identifying and addressing fraud, waste and abuse in Medicaid.
Page2-132LR3049(35)
SENATE AMENDMENT
SENATE AMENDMENT "P "to COMMITTEE AMENDMENT "A" to H.P, 1491, L.D. 2212 ('^>'l
3. Report by independent entity. The independent entity shall provide the
department with a final report regarding the independent entity's findings no later than
December 29, 2026.
4. Report by Department of Health and Human Services regarding MaineCare
fraud, waste and abuse. The Department of Health and Human Services shall submit a
report regarding the MaineCare program review for fraud, waste and abuse conducted
pursuant to this section and any necessary implementing legislation to the joint standing
committee of the Legislature having jurisdiction over appropriations and financial affairs
by January 5, 2027. The joint standing committee shall report out a bill to the 133rd
Legislature in 2027.
See. IIII-4. Contingent effective date. That section of this Part that enacts the
Maine Revised Statutes, Title 22, section 3198 does not take effect unless approval of a
Section 1115 demonstration waiver pursuant to section 2 of this Part is received.
The Commissioner of Health and Human Services shall notify the Secretary of State,
the Secretary of the Senate, the Clerk of the House and the Revisor of Statutes when
approval sought under section 2 of this Part is received.'
Amend the amendment by relettermg or renumbering any nonconsecutive Part letter or
section number to read consecutively,
SUMMARY
This amendment requires the Department of Health and Human Services to request a
demonstration waiver from the United States Department of Health and Human Services,
Centers for Medicare and Medicaid Services to place a freeze on the level of MlaineCare
enrollment by em'ollees who are able-bodied> childless adults. If the waiver is approved,
the amendment would require a freeze on enrollment for this classification of em'ollees
within 30 days of the effective date of this legislation and require the department to
gradually reduce enrollment by 10%, When enrollment has been reduced by 10%, the level
of enrollment at that time becomes the new permanent cap on enrollment for that
classification of enrollees and the freeze is lifted. The department must submit to the
Legislature quarterly reports of its progress in reducing enrollment. If the department's
progress is not satisfactory, the Legislature may impose additional program integrity
measures to ensure compliance.
This amendment also requires the Department of Health and Human Services to
contract, through a competitive bidding process, with a 3rd"party independent entity to
conduct a review of the MaineCare program for fraud, waste and abuse, based on specified
criteria, and to report to the department with its findings. It requires the department to
provide a report regarding the findings of the review of the MaineCare program for fraud,
waste and abuse to the joint standing committee of the Legislature having jurisdiction over
appropriations and financial affairs, along with any necessary implementing legislation,
SENATE AMENDMENT
SENATE AMENDMENT "(3_" to COMMITTEE AMENDMENT "A" to H,P. 1491, L.D,2212
The joint standing committee is reqiyred-to^report out a bill based on the report to the 133rd
Legislature in 2027.
SPONSORED BY:
(Senator STEWART, T.)
COUNTY: Aroostook
FISCAL NOTE REQUDIED
(See attached)
Page4-132LR3049(35)
SENATE AMENDMENT
Approved; 04/08/26
LR t.
LD 2212 LR 3049(35)
An Act Making Supplemental Appropriations and Allocations from the General Fund and Other
Funds for the Expenditures of State Government and Changing Certain Provisions of the Law
Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30,2026
and June 30, 2027
Fiscal Note for Senate Amendment t/h" to Committee Amendment "A"
Sponsor: Sen. Stewart of Aroostook
Fiscal Note Required: Yes
Fiscal Note
Current Biennium cost increase - General Fund
Contingent current biennium savings - General Fund
Fiscal Detail and Notes
This amendment also requires a third party independent review ofMaineCare, which would result in a cost increase.
This amendment also requires an enrollment freeze in the MaineCare program which would result in a savings. No
estimate of the net impact of the increase and savings are made at this time. A balanced budget is maintained.
LR3049(35) - Fiscal Note - Page 1 of 1