LD 1555
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LD 1555 Title Page An Act To Improve Quality, Effectiveness and Efficiency in the Department of He... Page 2 of 5
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LR 1641
Item 1

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

 
PART A

 
Sec. A-1. 22 MRSA §42, sub-§9 is enacted to read:

 
9.__Reimbursement, audit and appeal procedures.__Beginning
January 1, 2006, the following requirements apply to
reimbursement, audit and appeals procedures for community-based
organizations providing mental retardation and developmental
disabilities services to clients of the department through the
MaineCare program or through contract or agreement with the
department.__These procedures apply in addition to the procedures
otherwise required by law or rule.

 
A.__In the principles of reimbursement, the department shall
adopt a standard definition of "allowable costs" for all
principles of reimbursement unless federal law or regulation
specifically prohibits the use of the definition for a
particular program.

 
B.__The principles of reimbursement for private nonmedical
institutions must enable community-based organizations
operating private nonmedical institutions to shift variable
cost funds within certain designated accounts provided that
the totals are met for the private nonmedical institution.

 
C.__The department shall publish on its publically
accessible site on the Internet all interpretations of the
application of the principles of reimbursement by the
department's auditors.

 
D.__When a new interpretation of the application of the
principles of reimbursement is made by the department and a
previously allowed practice is disallowed by the department
through an audit, a new practice replacing the previously
allowed practice may not be required prior to the beginning
of the next fiscal year after the audit is completed.

 
E.__Appeals by a community-based organization regarding
programmatic and budgetary issues must be conducted for the
department by an independent decisionmaker.

 
F.__If a community-based organization is successful in an
appeal against the department, the decisionmaker shall award
to the organization as an allowable cost the cost of legal
fees and representation in the appeal.

 
Sec. A-2. Pilot project. The Department of Health and Human Services
shall conduct a pilot project to determine the efficacy of
accepting audits by certified public accountants


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