Whereas, certain current practices of the Department of Human Services in its zealous efforts to recover alleged overpayments by the MaineCare program may have the unintended and undesirable consequence of forcing legitimate providers of goods and services out of business or out of participation in MaineCare, thus reducing competition and driving up health care costs; and

Whereas, measures to ensure fairness in the review and decision-making process in cases involving such alleged overpayments can prevent excessive recoveries and unnecessary business closures by ensuring that sanctions and recoveries are commensurate with the magnitude of any errors that actually occurred, based on a careful review of the facts; and

Whereas, in the judgment of the Legislature, these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety; now, therefore,

Be it enacted by the People of the State of Maine as follows:

PART A

Sec. A-1. 22 MRSA §42, sub-§7, as enacted by PL 2001, c. 666, Pt. C, §1, is amended to read:

7. Appeal process. The department shall amend the rules governing appeals of informal review decisions of Medicaid MaineCare payment and cost report audit and review issues filed by service providers of nursing facility services and medical and remedial private nonmedical institution services or initiated by the department and any other informal review decisions that seek to impose repayment, recovery or recoupment obligations or sanctions or fines on service providers as provided in this subsection.

A. The department shall give to the service provider involved in an informal review decision written notice of the appeal process and the time period for filing a notice of appeal.

B. The department shall contract with a person or persons who are not employees of the department for independent, impartial hearing officer services.