LD 1356
pg. 4
Page 3 of 4 PUBLIC Law Chapter 419 LD 1356 Title Page
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LR 1441
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§48.__Provider relations

 
Department personnel assigned to MaineCare provider relations
shall assist MaineCare providers in addressing and resolving in a
cost-effective and expeditious manner any disagreements between
the department and providers or groups of providers.__Provider
relations personnel shall receive and investigate complaints and
concerns from providers regarding the MaineCare program and the
MaineCare reimbursement prior to informal review or
administrative hearing.__In performing their duties under this
subsection, the provider relations personnel must have access to
the Director of the Bureau of Medical Services.__The department
shall implement the provisions of this section within existing
resources.

 
Sec. 4. 22 MRSA §1714-A, sub-§2, as amended by PL 2001, c. 596, Pt. B,
§4 and affected by §25, is further amended to read:

 
2. Establishment of debt. A debt is established by the
department when it notifies a provider of debt that the provider
owes the department pursuant to a final reconciliation decision
and order that constitutes final agency action. A debt is
collectible by the department 31 days after exhaustion of all
administrative appeals and any judicial review available under
Title 5, chapter 375.

 
Sec. 5. 22 MRSA §1714-A, sub-§5, as enacted by PL 1991, c. 568, §4, is
amended to read:

 
5. Department may offset. The department may offset against
current reimbursement owed to a provider or any entity related by
ownership or control to that provider any debt it is owed by that
provider after the debt becomes collectible. The department
shall adopt rules that implement this subsection and define the
ownership or control relationships that are subject to an offset
under this subsection.__Rules adopted pursuant to this subsection
are routine technical rules as defined in Title 5, chapter 375,
subchapter 2-A.

 
Sec. 6. Complaint resolution and informal hearing process recommendations. By
January 5, 2004, the Department of Human Services and the Department of
Behavioral and Developmental Services, in conjunction with their duties
with regard to merger of the 2 departments under Public Law 2003, chapter
20, Part K, section 18, shall report to the Joint Standing Committee on
Health and Human Services recommendations to improve the MaineCare
complaint resolution and informal hearing process that ensure that
MaineCare providers receive fair and impartial complaint resolution
procedures and informal hearings.


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