SP0219
LD 629
Session - 126th Maine Legislature
 
LR 287
Item 1
Bill Tracking, Additional Documents Chamber Status

An Act To Restore Eligibility and Funding for Drug Programs for the Elderly and Disabled

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

Sec. 1. 22 MRSA §254-D, sub-§4, ¶D,  as amended by PL 2011, c. 657, Pt. HH, §1, is further amended to read:

D.  Income eligibility of individuals must be determined by this paragraph and by reference to the federal poverty guidelines for the 48 contiguous states and the District of Columbia, as defined by the federal Office of Management and Budget and revised annually in accordance with the United States Omnibus Budget Reconciliation Act of 1981, Section 673, Subsection 2, Public Law 97-35, reauthorized by Public Law 105-285, Section 201 (1998). If the household income is not more than 175% 185% of the federal poverty guideline applicable to the household, the individual is eligible for the basic program and the supplemental program. Individuals are also eligible for the basic and the supplemental program if the household spends at least 40% of its income on unreimbursed direct medical expenses for prescription drugs and medications and the household income is not more than 25% higher than the levels specified in this paragraph. For the purposes of this paragraph, the cost of drugs provided to a household under this section is considered a cost incurred by the household for eligibility determination purposes.

Sec. 2. Medicaid state plan amendment for the Medicare savings program. Notwithstanding Public Law 2011, chapter 657, Part HH, section 2, the Department of Health and Human Services shall prepare and submit a Medicaid state plan amendment to the federal Centers for Medicare and Medicaid Services that, effective October 1, 2013, effectively increases income eligibility levels for the Medicare savings program as follows: for the Qualified Medicare Beneficiary program, to income not more than 150% of the federal poverty level; for the Specified Low-Income Medicare Beneficiary program, to income more than 150% but not more than 170% of the federal poverty level; and for the Qualified Individuals program, to income more than 170% but not more than 185% of the federal poverty level.

Sec. 3. Appropriations and allocations. The following appropriations and allocations are made.

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)

FHM - Drugs for the Elderly and Disabled Z015

Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings program.

FUND FOR A HEALTHY MAINE 2013-14 2014-15
All Other
$1,219,908 $1,626,544
inline graphic sline.gif inline graphic sline.gif
FUND FOR A HEALTHY MAINE TOTAL $1,219,908 $1,626,544

FHM - Medical Care 0960

Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings program.

FUND FOR A HEALTHY MAINE 2013-14 2014-15
All Other
($1,219,908) ($1,626,544)
inline graphic sline.gif inline graphic sline.gif
FUND FOR A HEALTHY MAINE TOTAL ($1,219,908) ($1,626,544)

Low-cost Drugs To Maine's Elderly 0202

Initiative: Provides funding to restore the upper income eligibility level for the Low-cost Drugs to Maine's Elderly program from 175% to 185% of the federal poverty level.

GENERAL FUND 2013-14 2014-15
All Other
$112,154 $149,538
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GENERAL FUND TOTAL $112,154 $149,538

Medical Care - Payments to Providers 0147

Initiative: Adjusts funding to restore income eligibility levels for the Medicare savings program.

GENERAL FUND 2013-14 2014-15
All Other
$1,219,908 $1,626,544
inline graphic sline.gif inline graphic sline.gif
GENERAL FUND TOTAL $1,219,908 $1,626,544

Medical Care - Payments to Providers 0147

Initiative: Restores funding for MaineCare hospital crossover payments as a result of restoring income eligibility levels for the Medicare savings program.

GENERAL FUND 2013-14 2014-15
All Other
$1,663,554 $2,218,072
inline graphic sline.gif inline graphic sline.gif
GENERAL FUND TOTAL $1,663,554 $2,218,072

FEDERAL EXPENDITURES FUND 2013-14 2014-15
All Other
$2,865,588 $3,820,785
inline graphic sline.gif inline graphic sline.gif
FEDERAL EXPENDITURES FUND TOTAL $2,865,588 $3,820,785

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
DEPARTMENT TOTALS 2013-14 2014-15
GENERAL FUND
$2,995,616 $3,994,154
FEDERAL EXPENDITURES FUND
$2,865,588 $3,820,785
FUND FOR A HEALTHY MAINE
$0 $0
inline graphic sline.gif inline graphic sline.gif
DEPARTMENT TOTAL - ALL FUNDS $5,861,204 $7,814,939

Sec. 4. Contingent effective date. Section 2 of this Act takes effect only if:

1. The Commissioner of Health and Human Services receives written approval of the application for an increase in income eligibility levels as described in section 2 from the federal Centers for Medicare and Medicaid Services or the commissioner receives written notification from the Centers for Medicare and Medicaid Services that such approval is not necessary; and

2. The Commissioner of Health and Human Services notifies the Secretary of State, the Secretary of the Senate, the Clerk of the House of Representatives and the Revisor of Statutes that written approval of the application or written notification that such approval is not necessary has been received.

summary

In Public Law 2011, chapter 657, Part HH, the Commissioner of Health and Human Services was directed to seek a waiver to reduce income eligibility levels for the Medicare savings program by 10%. The reduction of income eligibility levels was contingent on the grant of the waiver by the federal Centers for Medicare and Medicaid Services; the waiver was granted.

This bill instructs the Commissioner of Health and Human Services to submit an application to restore income eligibility levels for the Medicare savings program to the levels they were before the waiver was granted and makes the increase contingent upon the approval of the federal Centers for Medicare and Medicaid Services. This bill also makes adjustments to appropriations and allocations to reflect the increase in the eligibility levels.


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