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131st MAINE LEGISLATURE
FIRST SPECIAL SESSION-2023
Legislative Document No. 1972S.P. 806 In Senate, May 18, 2023
Resolve, to Improve Long-term Care for the People of Maine
(EMERGENCY)
Reference to the Committee on Health and Human Services suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by President JACKSON of Aroostook. Page 1 - 131LR0946(01)1 acts and resolves of the Legislature do not
2 become effective until 90 days after adjournment unless enacted as emergencies; and
3 this legislation requires changes to certain MaineCare reimbursement rates
4 and requires these changes to take effect July 1, 2023; and
5 in the judgment of the Legislature, these facts create an emergency within
6 the meaning of the Constitution of Maine and require the following legislation as
7 immediately necessary for the preservation of the public peace, health and safety; now,
8 therefore, be it
9
10 That, notwithstanding any provision of law to the
11 contrary, the Department of Health and Human Services shall rebase reimbursement rates,
12 effective July 1, 2023, to reflect the increased costs experienced by nursing facilities,
13 including, but not limited to, the cost of labor.
14
15 That the Department of Health and Human Services
16 shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67,
17 Principles of Reimbursement for Nursing Facilities, Section 22.3.3.4 to provide that,
18 effective July 1, 2023, the upper limit on the base year case mix and regionally adjusted
19 cost per day is the median multiplied by 130%.
20
21 That the
22 Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare
23 Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing
24 Facilities to provide, for the state fiscal year beginning July 1, 2023, that the reduction in
25 allowable cost per day in the fixed costs component based on minimal occupancy standards
26 applies only for an annual level of occupancy less than 50%.
27
28
29 That the Department of Health and Human Services shall amend its rules in
30 Chapter 101: MaineCare Benefits Manual, Chapter III, Section 97, Appendix C, Principles
31 of Reimbursement for Medical and Remedial Service Facilities and Chapter 115: Principles
32 of Reimbursement for Residential Care Facilities - Room and Board Costs to provide, for
33 the state fiscal year beginning July 1, 2023, that the reduction in allowable cost per day in
34 the fixed costs component based on minimal occupancy standards applies only for an
35 annual level of occupancy less than 50%.
36
37 That the Department of Health and Human
38 Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III,
39 Section 67, Principles of Reimbursement for Nursing Facilities to establish, beginning July
40 1, 2023, an add-on rate of $24.59 per resident day to be added to the direct care rate. The
41 add-on rate provided in this section is in effect until rebasing occurs under the Maine
42 Revised Statutes, Title 22, section 1708, subsection 3, paragraph F and all allowable costs
43 are included. Page 2 - 131LR0946(01)
1
2 That the Department of Health
3 and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual,
4 Chapter III, Section 97, Appendix C, Principles of Reimbursement for Medical and
5 Remedial Service Facilities and Chapter 115: Principles of Reimbursement for Residential
6 Care Facilities - Room and Board Costs to establish, beginning July 1, 2023, an add-on rate
7 of $36.16 per resident day to be added to the direct care rate. The add-on rate provided in
8 this section is in effect until rebasing occurs and all allowable costs are included.
9
10 That the Department of Health and Human Services shall fully
11 fund the add-on rates required by sections 5 and 6 from existing resources available due to
12 low occupancy of long-term care facilities that resulted in the department's not fully using
13 the total funds appropriated and allocated for long-term care facilities. If existing resources
14 are not sufficient to fully fund the add-on rates required by sections 5 and 6, the department
15 shall complete a rebasing before the next statutorily required rebasing.
16 That the following
17 appropriations and allocations are made.
18
19
20 Initiative: Provides ongoing funding for a high MaineCare utilization add-on payment to
21 private nonmedical institutions that care for residents who are older or disabled, or
22 PNMI-Cs.
GENERAL FUND
2023-24 2024-25All Other $2,427,500$2,427,500
____________________
GENERAL FUND TOTAL
$2,427,500$2,427,500
23
OTHER SPECIAL REVENUE FUNDS 2023-24 2024-25All Other $319,149 $319,149
____________________
OTHER SPECIAL REVENUE FUNDS TOTAL
$319,149 $319,149
28
29 takes effect when approved.
34
35 This resolve directs the Department of Health and Human Services to amend its rules
36 to provide:
37 1. For the state fiscal year beginning July 1, 2023, that the reduction in allowable cost
38 for low occupancy applies only for an annual level of occupancy less than 50% in nursing
39 facilities and so-called Appendix C private nonmedical institutions;
40 2. Beginning July 1, 2023, add-on rates to the direct care rates for nursing homes and
41 so-called Appendix C private nonmedical institutions; and
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33
35
36 Page 3 - 131LR0946(01)
1 3. Effective July 1, 2023, the upper limit on the base year case mix and regionally
2 adjusted cost per day is the median multiplied by 130%.
3 The resolve requires the Department of Health and Human Services to rebase
4 reimbursement rates, effective July 1, 2023, to reflect the increased costs experienced by
5 nursing facilities.
6 The resolve also provides ongoing funding for a high MaineCare utilization add-on
7 payment to private nonmedical institutions that care for residents who are older or disabled,
8 or PNMI-Cs.