131st MAINE LEGISLATURE
		LD 389		LR 921(01)
	An Act to Improve Rural Transportation and Access to Mental Health Care and Physical Health Care
	Preliminary Fiscal Impact Statement for Original Bill
	Sponsor: Rep. Madigan of Waterville
	Committee: Health and Human Services
	Fiscal Note Required: Yes
Preliminary Fiscal Impact Statement
			FY 2023-24	FY 2024-25	Projections  FY 2025-26	Projections  FY 2026-27
Net Cost (Savings)
	General Fund		$3,881,359	$3,881,359	$3,881,359	$3,881,359
Appropriations/Allocations
	General Fund		$3,881,359	$3,881,359	$3,881,359	$3,881,359
Fiscal Detail and Notes
	The Department of Health and Human Services will require General Fund appropriations of $3,881,359 in fiscal year 2023-24 and $3,881,359 in fiscal year 2024-25 to provide a MaineCare member with mental illness who is receiving adult community support services and who resides more than 10 miles away from the member's community support provider's office with nonemergency transportation services to and from medical and mental health appointments and to and from activities identified in the member's community support individual support plan. A provider may only be reimbursed for providing transportation when the cost of transportation is not a component of a rate paid for another service. Sections 17, 18, 20, 21, 29 and 65 of the MaineCare Benefits Manual note that transportation is included in most of the services rates and cannot be billed separately. By requiring these trips to be billable, the total number of NEMT trips will be increased and the cost will need to be covered by 100% General Fund dollars, since the Centers for Medicare and Medicaid Services will not allow payment for transportation twice. The costs above are only for Section 1 of the bill. Section 2 will also have a significant fiscal impact and will also be funded with 100% General Fund dollars. A more precise estimate of the fiscal impact of this section is not possible because data related to number of trips and length of those trips is not known at this time. A survey of providers would be required to identify this information.