LD 1356
pg. 1
LD 1356 Title Page An Act To Provide Fair Hearing Procedures in the Department of Human Services ... Page 2 of 5
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LR 1441
Item 1

 
Emergency preamble. Whereas, Acts of the Legislature do not become
effective until 90 days after adjournment unless enacted as
emergencies; and

 
Whereas, certain current practices of the Department of Human
Services in its zealous efforts to recover alleged
overpayments by the MaineCare program may have the unintended
and undesirable consequence of forcing legitimate providers of
goods and services out of business or out of participation in
MaineCare, thus reducing competition and driving up health
care costs; and

 
Whereas, measures to ensure fairness in the review and
decision-making process in cases involving such alleged
overpayments can prevent excessive recoveries and unnecessary
business closures by ensuring that sanctions and recoveries
are commensurate with the magnitude of any errors that
actually occurred, based on a careful review of the facts; 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,

 
Be it enacted by the People of the State of Maine as follows:

 
PART A

 
Sec. A-1. 22 MRSA §42, sub-§7, as enacted by PL 2001, c. 666, Pt. C,
§1, is amended to read:

 
7. Appeal process. The department shall amend the rules
governing appeals of informal review decisions of Medicaid
MaineCare payment and cost report audit and review issues
filed by service providers of nursing facility services and
medical and remedial private nonmedical institution services
or initiated by the department and any other informal review
decisions that seek to impose repayment, recovery or
recoupment obligations or sanctions or fines on service
providers as provided in this subsection.

 
A. The department shall give to the service provider
involved in an informal review decision written notice of
the appeal process and the time period for filing a notice
of appeal.

 
B. The department shall contract with a person or persons
who are not employees of the department for independent,
impartial hearing officer services.


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