Resolve, To Classify Employee Health Insurance as a Fixed Cost for MaineCare Reimbursement in Nursing Homes

Sec. 1. Amendment of Principles of Reimbursement for Nursing Facilities. Resolved: That the Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities no later than January 1, 2020 as follows.

1. The costs of health insurance for those personnel currently included in the direct care cost component in section 16.1.7(3) must be removed from the direct care cost component and included in the fixed costs component in section 18.

2. The costs of health insurance for those personnel currently included in the routine cost component in section 17.4.1(o)(3) must be removed from the routine cost component and included in the fixed costs component in section 18.

SUMMARY

This resolve requires the Department of Health and Human Services to amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 67, Principles of Reimbursement for Nursing Facilities no later than January 1, 2020 to move health insurance costs for personnel from direct care and routine cost components to fixed costs components. This was a majority recommendation of the Commission To Study Long-term Care Facilities, which reported in December 2013.