Resolve, To Evaluate MaineCare Finances

Sec. 1. Office of Program Evaluation and Government Accountability to commission study. Resolved: That the Office of Program Evaluation and Government Accountability shall commission a study for a comprehensive analysis of MaineCare finances through a subcontract with an independent analyst that has no direct connection to State Government. The study must be completed in time to report pursuant to section 2 and must analyze the following issues, breaking down the analysis, when applicable, into per enrollee per month and per enrollee in the aggregate, comparing the State with the average of other states and distinguishing between services and covered individuals that are mandated by federal law and that are discretionary:

1. The distribution of MaineCare costs by age, type of service and enrollment category;

2. The portion of MaineCare expenses attributable to individuals required to be covered by the Federal Government and to individuals covered through the discretion of MaineCare due to Medicaid expansions;

3. The portion of MaineCare expenses attributable to services required to be provided by federal law and to expenses provided through the discretion of MaineCare due to Medicaid expansions;

4. The range and average of procedure-specific reimbursement rates among the states and how they compare with reimbursement rates in the State;

5. The range in frequency of use of specific medical services and procedures and key service categories in the State as compared with the national average, for both federally mandated enrollees and all enrollees;

6. The extent to which MaineCare has maximized its opportunities for federal funds; and

7. The range among the states in premium contributions by enrollees and patient deductibles and copayments for covered services and how they compare with the State; and be it further

Sec. 2. Report. Resolved: That, no later than January 15, 2009, the Office of Program Evaluation and Government Accountability shall report the results of the study under section 1, along with any recommended legislation, to the joint standing committee of the Legislature having jurisdiction over health and human services matters in the First Regular Session of the 124th Legislature. The joint standing committee of the Legislature having jurisdiction over health and human services matters may submit legislation related to the report to the First Regular Session of the 124th Legislature; and be it further

Sec. 3. Appropriations and allocations. Resolved: That the following appropriations and allocations are made.

PROGRAM EVALUATION AND GOVERNMENT ACCOUNTABILITY, OFFICE OF

MaineCare Financial Study

Initiative: Provides funds for the Office of Program Evaluation and Government Accountability to commission a study to analyze MaineCare’s finances.

GENERAL FUND	2007-08	2008-09
All Other	$1,000,000	$0
GENERAL FUND TOTAL	$1,000,000	$0

summary

This bill makes a one-time General Fund appropriation of $1,000,000 in fiscal year 2007-08 to provide funds to the Office of Program Evaluation and Government Accountability to commission a study to analyze MaineCare’s finances through a subcontract with an independent analyst that has no direct connection to State Government.