An Act To Strengthen the State's Ability To Investigate and Prosecute Misuse of Public Benefits
Sec. 1. 17-A MRSA §905-C is enacted to read:
§ 905-C. Misuse of public benefits instrument
Sec. 2. 22 MRSA §13, sub-§6, ¶B, as amended by PL 2003, c. 688, Pt. C, §6, is further amended to read:
Sec. 3. 22 MRSA §21, sub-§4, as enacted by PL 1995, c. 675, §1, is amended to read:
Sec. 4. 22 MRSA §23 is enacted to read:
§ 23. Unauthorized use of electronic benefits transfer system
Sec. 5. 22 MRSA §1714-A, sub-§1, ¶C, as enacted by PL 1991, c. 9, Pt. G, §4, is amended to read:
Sec. 6. 22 MRSA §1714-A, sub-§1, ¶¶I and J, as enacted by PL 1991, c. 9, Pt. G, §4, are amended to read:
(1) The department reimbursing a person other than the former provider for the provision of care or services; or
(2) The discontinuation of the provision of care or services.
Sec. 7. 22 MRSA §1714-A, sub-§4, ¶¶A and B, as enacted by PL 1991, c. 9, Pt. G, §4, are amended to read:
(1) All debts owed by the former provider to the department have been paid, except as stated in subparagraph (2);
(2) If the indebtedness is the subject of an administrative appeal, an escrow account has been created and funded in an amount sufficient to cover the debt as claimed by the department; or
(3) An interim cost report has:
(a) Been filed and an escrow account has been created and funded in an amount sufficient to cover any overpayment identified in the report; or
(b) Not been filed and an escrow account has been created and funded in an amount sufficient to cover 5% of Medicaid reimbursement or cost reimbursement for the last fiscal year or $50,000, whichever is less.
Sec. 8. 22 MRSA §1714-A, sub-§4, ¶C, as amended by PL 1991, c. 568, §2, is further amended to read:
Sec. 9. 22 MRSA §1714-D is enacted to read:
§ 1714-D. Credible allegations of fraud; provider payment suspensions
If the department determines that there is a credible allegation of fraud by a provider under the MaineCare program, the following procedures apply.
Sec. 10. 22 MRSA §3104, sub-§12, as amended by PL 2009, c. 291, §2, is further amended to read:
Sec. 11. 22 MRSA §3811, sub-§3, as amended by PL 1997, c. 466, §27 and affected by §28, is further amended to read:
Sec. 12. 22 MRSA §3811, sub-§4, as amended by PL 1997, c. 683, Pt. C, §9 and affected by §10, is further amended to read:
Sec. 13. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Office of Family Independence Z020
Initiative: Establishes 8 Fraud Investigator positions and 2 Office Associate II positions and related All Other funded 50% from the General Fund and 50% from Other Special Revenue Funds in the Office of Family Independence.
GENERAL FUND | 2011-12 | 2012-13 |
Personal Services
|
$0 | $313,011 |
All Other
|
$0 | $19,643 |
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|
GENERAL FUND TOTAL | $0 | $332,654 |
OTHER SPECIAL REVENUE FUNDS | 2011-12 | 2012-13 |
POSITIONS - LEGISLATIVE COUNT
|
0.000 | 10.000 |
Personal Services
|
$0 | $313,011 |
All Other
|
$0 | $28,837 |
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|
OTHER SPECIAL REVENUE FUNDS TOTAL | $0 | $341,848 |
SUMMARY
This bill provides successor liability for all health care providers in the MaineCare program; prohibits misuse of public benefits instruments; authorizes administrative recovery of improperly received municipal general assistance and MaineCare benefits; bans the use of electronic benefits transfer system benefits at liquor stores, gambling facilities and adult entertainment businesses; criminalizes the trafficking of electronic benefits by making the unauthorized transfer or possession of electronic benefits devices a Class D crime; conforms Maine law to federal requirements regarding suspension of payments to MaineCare providers upon determination of a credible allegation of fraud; and adds 8 Fraud Investigator and 2 Office Associate II positions to the Department of Health and Human Services, Office of Family Independence.