Resolve, To Ensure Access to Speech and Hearing Services

Sec. 1. Maximization of private insurance. Resolved: That the Department of Education shall maximize private insurance reimbursement to the Child Development Services System and the Department of Health and Human Services shall maximize private insurance reimbursement for MaineCare services in order to minimize expenditures in the Child Development Services System and the MaineCare program. Expenditures avoided through maximization of the use of private insurance under this section must be used to fund the MaineCare rate increases in section 2; and be it further

Sec. 2. Speech and hearing rate increase. Resolved: That by October 1, 2009 the Department of Health and Human Services shall increase the rates of reimbursement for speech and hearing services provided through speech and hearing agencies in the MaineCare Benefits Manual, Chapter II, Section 109 and Chapter III, Section 109. The new rates of reimbursement must increase the rates set in 1999 by the increase since 1999 in the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index. The new reimbursement rates must comply with federal Medicaid requirements for billing codes, must result in an increase over reimbursement rates paid in 2008 and may not result in decreased reimbursement rates for any speech and hearing agency services. Rules adopted pursuant to this section are routine technical rules as defined by the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A; and be it further

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

EDUCATION, DEPARTMENT OF

Preschool Handicapped 0449

Initiative: Deappropriates funds from enhanced private insurance reimbursements to the Child Development Services System.

GENERAL FUND	2009-10	2010-11
All Other	($100,000)	($102,700)
GENERAL FUND TOTAL	($100,000)	($102,700)

Preschool Handicapped 0449

Initiative: Appropriates funds to increase reimbursement rates for speech and hearing services provided through speech and hearing agencies.

GENERAL FUND	2009-10	2010-11
All Other	$100,000	$102,700
GENERAL FUND TOTAL	$100,000	$102,700

EDUCATION, DEPARTMENT OF
DEPARTMENT TOTALS	2009-10	2010-11
GENERAL FUND	$0	$0
DEPARTMENT TOTAL - ALL FUNDS	$0	$0

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)

Medical Care - Payments to Providers 0147

Initiative: Deappropriates funds by increasing 3rd-party liability collections from MaineCare members.

GENERAL FUND	2009-10	2010-11
All Other	($100,000)	($102,700)
GENERAL FUND TOTAL	($100,000)	($102,700)

FEDERAL EXPENDITURES FUND	2009-10	2010-11
All Other	($180,978)	($185,864)
FEDERAL EXPENDITURES FUND TOTAL	($180,978)	($185,864)

Medical Care - Payments to Providers 0147

Initiative: Appropriates funds to increase MaineCare reimbursement rates for speech and hearing services provided through speech and hearing agencies.

GENERAL FUND	2009-10	2010-11
All Other	$100,000	$102,700
GENERAL FUND TOTAL	$100,000	$102,700

FEDERAL EXPENDITURES FUND	2009-10	2010-11
All Other	$180,978	$185,864
FEDERAL EXPENDITURES FUND TOTAL	$180,978	$185,864

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
DEPARTMENT TOTALS	2009-10	2010-11
GENERAL FUND	$0	$0
FEDERAL EXPENDITURES FUND	$0	$0
DEPARTMENT TOTAL - ALL FUNDS	$0	$0

SECTION TOTALS	2009-10	2010-11
GENERAL FUND	$0	$0
FEDERAL EXPENDITURES FUND	$0	$0
SECTION TOTAL - ALL FUNDS	$0	$0

SUMMARY

This resolve directs the Department of Health and Human Services to increase by rule the rates of reimbursement under the MaineCare program set in 1999 for speech and hearing services provided through speech and hearing agencies by the increase since 1999 in the federal Consumer Price Index. The new reimbursement rates must comply with federal Medicaid requirements for billing codes, must result in an increase over reimbursement rates paid in 2008 and may not result in decreased reimbursement rates for any speech and hearing agency services. The new rules are designated as routine technical rules. The resolve also requires the Department of Education to maximize private insurance reimbursement to the Child Development Services System and the Department of Health and Human Services to maximize private insurance reimbursement for MaineCare services and directs savings to the speech and hearing agency reimbursement increase.

The resolve includes an appropriations and allocations section that appropriates funds to increase reimbursement rates for speech and hearing services and deappropriates funds by increasing 3rd-party liability collections from MaineCare members and from enhanced private insurance reimbursements to the Child Development Services System.