HP1304, LD 1868, item 2, Document Text

Amend the resolve by striking out everything after the emergency preamble and before the emergency clause and inserting the following:

‘Sec. 1. Department of Health and Human Services to increase MaineCare reimbursement for outpatient psychosocial treatments for children. Resolved: That the Department of Health and Human Services shall increase reimbursement rates under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 65 for multisystemic therapy, multisystemic therapy for problem sexualized behavior and functional family therapy by 20% for the period from the effective date of this resolve to June 30, 2019; and be it further

Sec. 2. Rate study. Resolved: That the Department of Health and Human Services shall contract with a 3rd party to conduct a rate study of reimbursement rates under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 65 for multisystemic therapy, multisystemic therapy for problem sexualized behavior and functional family therapy. The rate study must develop a rate that is set on a per case per week basis. The rate study must also take into account the costs to providers of delivering the services, including additional training, and maintenance of fidelity to the treatment models. The rate study must be completed no later than December 1, 2018; and be it further

Sec. 3. Report. Resolved: That the Department of Health and Human Services shall submit a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters with the findings of the rate study conducted pursuant to section 2 no later than January 30, 2019; and be it further

Sec. 4. Rulemaking. Resolved: That the Department of Health and Human Services is authorized to adopt rules to implement new rates developed pursuant to the rate study in section 2 as long as those rates are no lower than the rates of reimbursement that exist on April 1, 2018 and the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services approves the reimbursement rates. Rules adopted pursuant to this section are routine technical rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A; and be it further

Sec. 5. Appropriations and allocations. Resolved: That the following appropriations and allocations are made.

HEALTH AND HUMAN SERVICES, DEPARTMENT OF

Medical Care - Payments to Providers 0147

Initiative: Provides funding for a one-time increase to certain rates under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 65 by 20% until June 30, 2019.

GENERAL FUND 2017-18 2018-19

All Other
$0 $212,306

inline graphic sline.gif

GENERAL FUND TOTAL $0 $212,306

FEDERAL EXPENDITURES FUND 2017-18 2018-19

All Other
$0 $385,318

inline graphic sline.gif

FEDERAL EXPENDITURES FUND TOTAL $0 $385,318

Office of MaineCare Services 0129

Initiative: Provides funding to contract with a 3rd party to conduct a rate study of certain rates under rule Chapter 101: MaineCare Benefits Manual, Chapters II and III, Section 65 to be completed no later than December 1, 2018.

GENERAL FUND 2017-18 2018-19

All Other
$0 $50,000

inline graphic sline.gif

GENERAL FUND TOTAL $0 $50,000

FEDERAL EXPENDITURES FUND 2017-18 2018-19

All Other
$0 $50,000

inline graphic sline.gif

FEDERAL EXPENDITURES FUND TOTAL $0 $50,000

HEALTH AND HUMAN SERVICES, DEPARTMENT OF

DEPARTMENT TOTALS 2017-18 2018-19

GENERAL FUND
$0 $262,306

FEDERAL EXPENDITURES FUND
$0 $435,318

inline graphic sline.gif

DEPARTMENT TOTAL - ALL FUNDS $0 $697,624

’

summary

This amendment, which is the majority report of the committee, replaces the resolve. It requires the Department of Health and Human Services to increase reimbursement rates for multisystemic therapy, multisystemic therapy for problem sexualized behavior and functional family therapy by 20% until June 30, 2019. It requires the department to contract for a 3rd-party rate study of the reimbursement rates for those therapies, including developing a rate set on a per case per week basis rather than the current 15-minute increments. The rate study must also take into account the costs to providers of delivering the services, including additional training, and maintenance of fidelity to the treatment models. The rate study must be completed no later than December 1, 2018. The department must submit a report on the results of the study to the joint standing committee of the Legislature having jurisdiction over health and human services matters no later than January 30, 2019. The department is authorized to implement new rates through rulemaking as long as the rates are no lower than those that exist on April 1, 2018 and the rates are approved by the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services. It also adds an appropriations and allocations section.

FISCAL NOTE REQUIRED

(See attached)

HP1304 LD 1868	Session - 128th Maine Legislature C "A", Filing Number H-729, Sponsored by		LR 2909 Item 2
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GENERAL FUND	2017-18	2018-19
All Other	$0	$212,306

GENERAL FUND TOTAL	$0	$212,306

FEDERAL EXPENDITURES FUND	2017-18	2018-19
All Other	$0	$385,318

FEDERAL EXPENDITURES FUND TOTAL	$0	$385,318

HEALTH AND HUMAN SERVICES, DEPARTMENT OF
DEPARTMENT TOTALS	2017-18	2018-19

GENERAL FUND	$0	$262,306
FEDERAL EXPENDITURES FUND	$0	$435,318

DEPARTMENT TOTAL - ALL FUNDS	$0	$697,624