Amend the bill by striking out all of section 5 and inserting the following:
‘Sec. 5. 34-B MRSA §1409, sub-§11, ¶C is enacted to read:
C.
For a resident receiving services, including medical care, goods, prescription drugs and other medications, outside a state institution, the commissioner may pay the provider of those services an amount no greater than the following:
(1) For residents that have insurance, the amount that would be payable pursuant to any insurance benefit, including Medicare, that the resident is eligible to receive;
(2) For physicians and hospitals that are not designated critical access hospitals, the reimbursement rate applicable to that provider and that service, as established by rule by the department for the MaineCare program under Title 22, divided by 75%; or
’ (3) For all other providers, the reimbursement rate applicable to that provider and that service, as established by rule by the department for the MaineCare program under Title 22.
Amend the bill by adding after section 6 the following:
‘Sec. 7. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS)
Disproportionate Share - Dorothea Dix Psychiatric Center 0734
Initiative: Reduces funding from savings from limiting reimbursement for medical services provided to a resident of a state institution outside of a state institution.
| GENERAL FUND |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($4,786) |
|
 |
|
| GENERAL FUND TOTAL |
$0 |
($4,786) |
Disproportionate Share - Riverview Psychiatric Center 0733
Initiative: Reduces funding from savings from limiting reimbursement for medical services provided to a resident of a state institution outside of a state institution.
| GENERAL FUND |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($41,318) |
|
|
|
| GENERAL FUND TOTAL |
$0 |
($41,318) |
Dorothea Dix Psychiatric Center 0120
Initiative: Reduces funding from savings from limiting reimbursement for medical services provided to a resident of a state institution outside of a state institution.
| GENERAL FUND |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($2,525) |
|
|
|
| GENERAL FUND TOTAL |
$0 |
($2,525) |
| OTHER SPECIAL REVENUE FUNDS |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($9,691) |
|
|
|
| OTHER SPECIAL REVENUE FUNDS TOTAL |
$0 |
($9,691) |
Riverview Psychiatric Center 0105
Initiative: Reduces funding from savings from limiting reimbursement for medical services provided to a resident of a state institution outside of a state institution.
| GENERAL FUND |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($8,492) |
|
|
|
| GENERAL FUND TOTAL |
$0 |
($8,492) |
| OTHER SPECIAL REVENUE FUNDS |
2011-12 |
2012-13 |
|
All Other
|
$0 |
($78,190) |
|
|
|
| OTHER SPECIAL REVENUE FUNDS TOTAL |
$0 |
($78,190) |
| HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY BDS) |
|
|
| DEPARTMENT TOTALS |
2011-12 |
2012-13 |
|
|
|
|
GENERAL FUND
|
$0 |
($57,121) |
|
OTHER SPECIAL REVENUE FUNDS
|
$0 |
($87,881) |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS |
$0 |
($145,002) |
’
summary
This amendment, which is the minority report of the committee, limits the amount that the Commissioner of Health and Human Services may pay a provider for medical services provided to a resident of a state institution off the premises of the state institution to the amount payable under insurance, including Medicare, for residents that have insurance; to the amount established by rule by the Department of Health and Human Services under the MaineCare program, divided by 75% for physicians and hospitals other than critical access hospitals; or to the MaineCare rate for all other providers. It also adds an appropriations and allocations section to the bill.
FISCAL NOTE REQUIRED
(See attached)