HP1006, LD 1465, item 2, Document Text

Amend the bill by striking out everything after the enacting clause and before the summary and inserting the following:

‘Sec. 1. 22 MRSA §3174-JJ, first ¶, as amended by PL 2013, c. 441, §1, is further amended to read:

The department shall reimburse for ambulance services under MaineCare at a level that is not less than the average allowable reimbursement rate under Medicare for such services or at the highest percent of that level that is possible within resources appropriated for those purposes. Beginning March 1, 2015, the department shall reimburse for ambulance services under MaineCare at a level that is not less than 65% of the average allowable reimbursement rate under Medicare for such services. Beginning August 1, 2016, the department shall reimburse for ambulance services under MaineCare at a level that is not less than 70% of the average allowable reimbursement rate under Medicare for such services.

Sec. 2. Rate study. The Department of Health and Human Services shall contract with a 3rd-party consultant to conduct a rate study of Chapter 101: MaineCare Benefits Manual, Section 5, Ambulance Services. The rate study must account for provider costs related to ambulance services. The rate study must also assess the feasibility of reimbursing for community paramedicine services and potential rates for those services. The 3rd-party consultant conducting the study under this section shall invite the participation of stakeholders providing ambulance services.

Sec. 3. Report. The Department of Health and Human Services, no later than January 1, 2017, shall submit a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters on the department's progress on developing a reimbursement rate for community paramedicine services pursuant to section 2 of this Act.

Sec. 4. Appropriations and allocations. The following appropriations and allocations are made.

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)

Medical Care - Payments to Providers 0147

Initiative: Provides funding to increase reimbursement for ambulance services to 70% of the Medicare allowable rate.

GENERAL FUND 2015-16 2016-17

All Other
$0 $443,329

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GENERAL FUND TOTAL $0 $443,329

FEDERAL EXPENDITURES FUND 2015-16 2016-17

All Other
$0 $786,433

inline graphic sline.gif

FEDERAL EXPENDITURES FUND TOTAL $0 $786,433

’

SUMMARY

This amendment replaces the bill and increases the reimbursement rate for ambulance services under MaineCare from the current no less than 65% of the average allowable reimbursement rate under Medicare for such services to no less than 70%, rather than to the Medicare rate as in the bill. This amendment also requires the Department of Health and Human Services to contract with a 3rd-party consultant to conduct a rate study on ambulance services. The rate study must include the feasibility of developing community paramedicine reimbursement rates. The Department of Health and Human Services is required to submit a report on developing a reimbursement rate for community paramedicine programs to the joint standing committee of the Legislature having jurisdiction over health and human services matters no later than January 1, 2017. The amendment also adds an appropriations and allocations section.

FISCAL NOTE REQUIRED

(See attached)

HP1006 LD 1465	Session - 127th Maine Legislature C "A", Filing Number H-547, Sponsored by		LR 2354 Item 2
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GENERAL FUND	2015-16	2016-17
All Other	$0	$443,329

GENERAL FUND TOTAL	$0	$443,329

FEDERAL EXPENDITURES FUND	2015-16	2016-17
All Other	$0	$786,433

FEDERAL EXPENDITURES FUND TOTAL	$0	$786,433