‘Resolve, Regarding Reimbursement for Speech and Language Pathology Services’
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. Department of Health and Human Services to increase MaineCare reimbursement rates. Resolved: That, no later than January 1, 2018, the Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109 to increase reimbursement rates for speech-language pathology services provided by an agency to no less than 69% of the federal Medicare reimbursement rate for these services as long as the rate is no lower than the rate reimbursed as of January 1, 2017; and be it further
Sec. 2. Independent rates. Resolved: That, no later than January 1, 2018, the Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109 to increase reimbursement rates for speech-language pathology services provided by an independent speech-language pathologist to 90% of the agency rate established in section 1 as long as the rate is no lower than the rate reimbursed as of January 1, 2017; and be it further
Sec. 3. Speech-language pathology assistant agency rates. Resolved: That, no later than January 1, 2018, the Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109 to reimburse services provided by an agency speech-language pathology assistant for treatment within a group of 2 or more individuals at 69% of the federal Medicare reimbursement rate for the same service provided by a speech-language pathologist; and be it further
Sec. 4. Speech-language pathology assistant independent rates. Resolved: That, no later than January 1, 2018, the Department of Health and Human Services shall amend its rules in Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109 to reimburse services provided by an independent speech-language pathology assistant for treatment within a group of 2 or more individuals at 90% of the agency rate established in section 3 as long as the rate is no lower than the rate reimbursed as of January 1, 2017. Services provided by independent speech-language pathology assistants for individual treatment must be reimbursed at 90% of the agency rate reimbursed as of January 1, 2017; and be it further
Sec. 5. Routine technical rules. Resolved: That rules adopted pursuant to this resolve are routine technical rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A; and be it further
Sec. 6. 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: Provides appropriations and allocations for increased reimbursement of certain speech and language pathology services currently provided under Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109, Speech and Hearing Services.
| GENERAL FUND | 2017-18 | 2018-19 |
|
All Other
|
$182,457 | $182,509 |
 |
|
|
| GENERAL FUND TOTAL | $182,457 | $182,509 |
| FEDERAL EXPENDITURES FUND | 2017-18 | 2018-19 |
|
All Other
|
$329,345 | $329,294 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $329,345 | $329,294 |
SUMMARY
This amendment, which is the majority report of the committee, replaces the bill with a resolve. The amendment sets the reimbursement rates for speech and language pathology services provided by an agency under Department of Health and Human Services rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 109 at 69% of the federal Medicare rate as long as the reimbursement rate is no lower than the current rate. It establishes that services provided by independent speech-language pathologists are set at 90% of the reimbursement rate for agencies. The amendment also establishes reimbursement rates for agency speech-language pathology assistants for group therapy at 69% of the federal Medicare rate for equivalent services for speech-language pathologists since there is no established Medicare rate for assistants. Rates for agency assistants providing individual therapy do not change from the rate reimbursed as of January 1, 2017. Independent speech-language pathology assistant reimbursement rates are set at 90% of the agency rates for assistants. The amendment also adds an appropriations and allocations section.
FISCAL NOTE REQUIRED
(See attached)