‘Resolve, To Protect the State from Accumulating Future Hospital Debt’
Amend the bill by striking out the title and substituting the following:
Amend the bill by striking out everything after the title and before the summary and inserting the following:
‘Sec. 1. Payment of hospitals for MaineCare services. Resolved: That the provisions of this section apply to reimbursement under the MaineCare program for hospital services provided to MaineCare members performed beginning on the date on which a new reimbursement mechanism is implemented by the Department of Health and Human Services, referred to in this resolve as "the department." No later than 12 months following the department's receipt of a hospital's as-filed Medicare cost report and MaineCare supplemental data form, the department shall make interim settlement payments, if any, to the hospital. The interim settlement payments must be calculated using the same method as was used for prior prospective interim payments, except that the data source used for inpatient calculations is discharges and charges included in the MaineCare paid claims history for the year for which settlement is being performed. Any other calculations required in making the interim settlement payment must be based on the hospital's as-filed Medicare cost report, the MaineCare supplemental data form and the MaineCare paid claims history for the year for which settlement is being performed; and be it further
Sec. 2. Appropriations and allocations. Resolved: That the following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
Medical Care - Payments to Providers 0147
Initiative: Appropriates and allocates funds for hospital settlements.
| GENERAL FUND | 2011-12 | 2012-13 |
|
All Other
|
$0 | $11,475,187 |
 |
|
|
| GENERAL FUND TOTAL | $0 | $11,475,187 |
| FEDERAL EXPENDITURES FUND | 2011-12 | 2012-13 |
|
All Other
|
$0 | $19,766,813 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $0 | $19,766,813 |
summary
This amendment is the majority report of the committee. This amendment changes the bill to a resolve and requires the Department of Health and Human Services to use current hospital cost reports to calculate amounts owed to hospitals and to pay any amounts due within one year of receiving the reports. It also adds an appropriations and allocations section.
FISCAL NOTE REQUIRED
(See attached)