‘An Act To Clarify Medicaid Ombudsman Services’
HP1021 LD 1498 |
Session - 127th Maine Legislature C "A", Filing Number H-620, Sponsored by
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LR 2454 Item 2 |
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Bill Tracking, Additional Documents | Chamber Status |
Amend the bill by striking out the title and substituting the following:
‘An Act To Clarify Medicaid Ombudsman Services’
Amend the bill in section 1 in §3174-X in subsection 1 in paragraph A in the 2nd line (page 1, line 8 in L.D.) by inserting after the following: " Act." the following: ' "Children's health insurance program" includes the Cub Care program, which is established in section 3174-T, the federal Children's Health Insurance Program, or CHIP, and the federal State Children's Health Insurance Program, or S-CHIP.'
Amend the bill in section 1 in §3174-X in subsection 1 by striking out all of paragraph C (page 1, lines 11 to 16 in L.D.).
Amend the bill in section 1 in §3174-X in subsection 1 in paragraph E in the 2nd line (page 1, line 20 in L.D.) by inserting after the following: " workshops" the following: ' for members, eligible members and health care providers, social service providers and health insurance navigators, brokers and agents'
Amend the bill in section 1 in §3174-X in subsection 1 in paragraph E in the last line (page 1, line 25 in L.D.) by inserting after the following: " programs" the following: ' such as, but not limited to, prescription assistance programs'
Amend the bill in section 1 in §3174-X in subsection 1 by relettering the paragraphs to read alphabetically.
Amend the bill in section 1 in §3174-X in subsection 2 in the 2nd line (page 1, line 28 in L.D.) by striking out the following: " managed care"
Amend the bill in section 1 in §3174-X in subsection 2 in the 10th line (page 1, line 36 in L.D.) by inserting after the following: " navigators" the following: ' , brokers, agents'
Amend the bill in section 1 in §3174-X in subsection 2 in the last line (page 1, line 38 in L.D.) by inserting after the following: " program." the following: ' If members or eligible members described in this subsection are applying for or receiving long-term care home-based and community-based services or institutional services, ombudsman assistance for those services is provided by the long-term care ombudsman program established pursuant to section 5106, subsection 11-C. The program shall coordinate with the long-term care ombudsman program on activities, including but not limited to marketing, outreach and referral services.'
Amend the bill in section 1 in §3174-X in subsection 9 in the last line (page 3, line 16 in L.D.) by inserting after the following: " subsection 3." the following: ' The program shall also report annually by January 1st to the joint standing committee of the Legislature having jurisdiction over health and human services matters on the activities and services of the program, priorities that may have been set by the program among types of inquiries and complaints, waiting lists for services and the provision of outreach services and recommendations for changes in statute, rules or policy to improve the provision of services.'
Amend the bill in section 1 in §3174-X in subsection 10 in the 2nd and 3rd lines (page 3, lines 18 and 19 in L.D.) by striking out the following: ' for use as the state seed money for such a contract and General Fund money is not required'
summary
This amendment makes the following changes to the bill.
1. It clarifies that the children's health insurance program is also known as Cubcare, CHIP and S-CHIP.
2. It clarifies that the definition of "outreach and education" includes workshops for members, eligible members and health care providers, social service providers and health insurance navigators, brokers and agents and that screenings for eligibility include but are not limited to prescription assistance programs.
3. It strikes references to managed care, including in the title of the bill.
4. It clarifies that the long-term care ombudsman program established pursuant to the Maine Revised Statutes, Title 22, section 5106, subsection 11-C continues to provide services for those receiving long-term care home-based and community-based or institutional services.
5. It requires the Medicaid ombudsman program to provide annual reports to the joint standing committee of the Legislature having jurisdiction over health and human services matters.
6. It clarifies that the program may only be contracted for with nonstate funding and removes any references to state seed match.