126th MAINE LEGISLATURE
		LD 1776		LR 2744(05)
	An Act To Implement the Recommendations of the Commission To Study Long-term Care Facilities
	Fiscal Note for Senate Amendment " " to Committee Amendment "A"
	Sponsor: Sen. Craven of Androscoggin
	Fiscal Note Required: Yes
Fiscal Note
Legislative Cost/Study
			FY 2013-14	FY 2014-15	Projections  FY 2015-16	Projections  FY 2016-17
Net Cost (Savings)
	General Fund		$0	($12,086,114)	($3,104,218)	($3,101,218)
Appropriations/Allocations
	General Fund		$0	($12,086,114)	($3,104,218)	($3,101,218)
	Federal Expenditures Fund		$0	($8,114,611)	($6,244,378)	$146,755,622
	Other Special Revenue Funds		$0	($756,102)	($581,837)	($581,837)
Revenue
	Other Special Revenue Funds		$0	($756,102)	($581,837)	($581,837)
Legislative Cost/Study
	The amendment makes no changes to the bill's two separate commissions.
Fiscal Detail and Notes
	This fiscal note reflects the incremental impact of the amendment.  As a result of changes made to the nursing home reimbursement initiative the total appropriation for the initiative is reduced by $4.1 million in fiscal year 2014-15 in the Nursing Facilities program in the Department of Health and Human Services. The revised estimated impact is summarized in the table below.
					2014-15
	Nursing Facility Costs				Total Costs	State Share
	Cost of moving health insurance to fixed costs:		Direct Cost		$0	$0
			Routine Cost		$0	$0
	Supplemental payment for MaineCare days over 70% at $.40/day				$0	$0
	Additional cost of Management Allowance above ceiling (no limit)				$7,919,211	$3,025,376
	Rebasing routine cost CAP to 110% of median by peer group				$10,501,442	$4,011,866
	Rebasing direct care CAP to 110% of median by peer group				$5,156,554	$1,969,958
	Total Impact				$23,577,207	$9,007,200
	The amendment also includes a deappropriation of $8 million in fiscal year 2014-15 in the Medical Care- Payments to Providers program for recovery of overpayments to providers due to errors in calculating cost-of-care and for continued proper application of cost-of-care rules.  DHHS has indicated it had cost-of-care collections of $10.4 million in fiscal year 2012-13 and expects to recover $13.9 million in fiscal year 2013-14 and $9.0 million in fiscal year 2014-15.  DHHS has also indicated these recoveries have been included in their MaineCare shortfall forecast used to prepare the 2014-2015 supplemental budget request.  Accordingly, additional recoveries or savings above these amounts would be necessary to meet the $8 million deappropriation.