An Act To Prevent and Reduce Tobacco Use with Adequate Funding and by Equalizing the Taxes on Tobacco Products and To Improve Public Health
PART A
Sec. A-1. 36 MRSA §4401, sub-§§2-A, 2-B and 7-A are enacted to read:
Sec. A-2. 36 MRSA §4401, sub-§9, as amended by PL 2005, c. 627, §4, is further amended to read:
Sec. A-3. 36 MRSA §4403, sub-§1, as repealed and replaced by PL 2009, c. 213, Pt. H, §1 and affected by §3, is amended to read:
Beginning January 2, 2020, the tax rates in this subsection are subject to adjustment pursuant to subsection 5.
Sec. A-4. 36 MRSA §4403, sub-§2, as amended by PL 2005, c. 627, §8, is further amended to read:
Sec. A-5. 36 MRSA §4403, sub-§5 is enacted to read:
Sec. A-6. Appropriations and allocations. The following appropriations and allocations are made.
ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF
Revenue Services, Bureau of 0002
Initiative: Provides funding for one Tax Examiner position and related costs to review and process additional tobacco products tax returns.
| GENERAL FUND | 2019-20 | 2020-21 |
|
POSITIONS - LEGISLATIVE COUNT
|
1.000 | 1.000 |
|
Personal Services
|
$65,492 | $85,661 |
|
All Other
|
$12,089 | $2,700 |
 |
|
|
| GENERAL FUND TOTAL | $77,581 | $88,361 |
| ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF | ||
| DEPARTMENT TOTALS | 2019-20 | 2020-21 |
|
GENERAL FUND
|
$77,581 | $88,361 |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS | $77,581 | $88,361 |
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Maine Center for Disease Control and Prevention 0143
Initiative: Appropriates funds for evidence-based tobacco use prevention and cessation, in accordance with the United States Department of Health and Human Services, Centers for Disease Control and Prevention best practices.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$2,050,000 | $4,100,000 |
|
|
|
| GENERAL FUND TOTAL | $2,050,000 | $4,100,000 |
Medical Care - Payments to Providers 0147
Initiative: Appropriates and allocates funds for tobacco use cessation medications and counseling provided to MaineCare members.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$500,000 | $750,000 |
|
|
|
| GENERAL FUND TOTAL | $500,000 | $750,000 |
| FEDERAL EXPENDITURES FUND | 2019-20 | 2020-21 |
|
All Other
|
$1,776,235 | $1,332,177 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $1,776,235 | $1,332,177 |
| HEALTH AND HUMAN SERVICES, DEPARTMENT OF | ||
| DEPARTMENT TOTALS | 2019-20 | 2020-21 |
|
GENERAL FUND
|
$2,550,000 | $4,850,000 |
|
FEDERAL EXPENDITURES FUND
|
$1,776,235 | $1,332,177 |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS | $4,326,235 | $6,182,177 |
| SECTION TOTALS | 2019-20 | 2020-21 |
|
GENERAL FUND
|
$2,627,581 | $4,938,361 |
|
FEDERAL EXPENDITURES FUND
|
$1,776,235 | $1,332,177 |
|
|
|
| SECTION TOTAL - ALL FUNDS | $4,403,816 | $6,270,538 |
Sec. A-7. Effective date. Those sections of this Part that amend the Maine Revised Statutes, Title 36, section 4401, subsection 9 and that enact Title 36, section 4401, subsections 2-A, 2-B and 7-A take effect January 2, 2020.
PART B
Sec. B-1. 22 MRSA §3174-JJ, as amended by PL 2013, c. 441, §1, is further amended to read:
§ 3174-JJ. MaineCare reimbursement for ambulance services
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 January 1, 2020, 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 and shall reimburse for neonatal transport services under MaineCare at the average rate for critical care transport services under Medicare.
Sec. B-2. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Provides funding to increase the reimbursement rate for ambulance services under the MaineCare program so the rates are not less than the average allowable reimbursement rate under Medicare and increase the reimbursement rate for neonatal transport services under MaineCare so the rates are equal to the average rate for critical care transport services under Medicare.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$1,662,060 | $3,329,640 |
|
|
|
| GENERAL FUND TOTAL | $1,662,060 | $3,329,640 |
| FEDERAL EXPENDITURES FUND | 2019-20 | 2020-21 |
|
All Other
|
$4,894,815 | $5,868,260 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $4,894,815 | $5,868,260 |
PART C
Sec. C-1. 36 MRSA §5122, sub-§2, ¶QQ is enacted to read:
Sec. C-2. Reimbursement for rural hospitals and nonrural hospitals. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 45 in order to provide MaineCare reimbursement for rural hospitals at 100% of inpatient hospital-based physician costs, outpatient emergency room hospital-based physician costs, outpatient nonemergency room hospital-based physician costs and graduate medical education costs. The department shall also amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 45 in order to provide MaineCare reimbursement for nonrural hospitals at 93.3% of inpatient hospital-based physician costs, 93.4% of outpatient emergency room hospital-based physician costs and 83.8% of outpatient nonemergency room hospital-based physician costs.
The department shall adopt routine technical rules under the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A to establish a definition of "rural hospital" that reflects the regional access to hospital care and the population density of the public health district in which the hospital is located, as long as the following hospitals are considered rural hospitals:
1. Northern Light A.R. Gould Hospital in Presque Isle;
2. Cary Medical Center in Caribou;
3. Franklin Memorial Hospital in Farmington;
4. Northern Light Inland Hospital in Waterville;
5. Northern Light Maine Coast Hospital in Ellsworth; and
6. Northern Maine Medical Center in Fort Kent.
Sec. C-3. Reimbursement for acute care critical access hospitals. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter III, Section 45 regarding acute care critical access hospital physician services to require MaineCare reimbursement of 100% for all hospital-based physician costs.
Sec. C-4. Reimbursement for rural health clinics. The Department of Health and Human Services shall amend its rule Chapter 101: MaineCare Benefits Manual, Chapter II, Section 103 regarding the department's reimbursement methodology to provide an alternative payment methodology option that, effective January 1, 2020, is the same as the existing methodology except that rural health clinics may be reimbursed on the basis of 100% of the average of the reasonable costs of providing MaineCare-covered services during calendar years 2016 and 2017 as long as reimbursement is no less than reimbursement received under the prospective payment system described in Section 1902(bb) of the United States Social Security Act. Each rural health clinic must be given the option to be reimbursed under the methodology required by this section or under the existing prospective payment system methodology.
Sec. C-5. State plan amendments; rulemaking. The Department of Health and Human Services shall submit any necessary state plan amendments to implement the requirements of this Part to the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services no later than January 1, 2020. Upon approval, the department shall amend its rules within 180 days of approval. Rules adopted pursuant to this section are routine technical rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A.
Sec. C-6. Appropriations and allocations. The following appropriations and allocations are made.
HEALTH AND HUMAN SERVICES, DEPARTMENT OF
Medical Care - Payments to Providers 0147
Initiative: Provides appropriations and allocations to allow for MaineCare reimbursement of 100% for all hospital-based physician costs.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$371,768 | $753,736 |
|
|
|
| GENERAL FUND TOTAL | $371,768 | $753,736 |
| FEDERAL EXPENDITURES FUND | 2019-20 | 2020-21 |
|
All Other
|
$793,942 | $1,577,684 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $793,942 | $1,577,684 |
Medical Care - Payments to Providers 0147
Initiative: Provides appropriations and allocations to allow for MaineCare reimbursement for rural hospitals at 100% of inpatient hospital-based physician costs, outpatient emergency room hospital-based physician costs, outpatient nonemergency room hospital-based physician costs and graduate medical education costs and to allow for MaineCare reimbursement for nonrural hospitals at 93.3% of inpatient hospital-based physician costs, 93.4% of outpatient emergency room hospital-based physician costs and 83.8% of outpatient nonemergency room hospital-based physician costs.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$263,428 | $534,084 |
|
|
|
| GENERAL FUND TOTAL | $263,428 | $534,084 |
| FEDERAL EXPENDITURES FUND | 2019-20 | 2020-21 |
|
All Other
|
$562,573 | $1,117,918 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $562,573 | $1,117,918 |
Medical Care - Payments to Providers 0147
Initiative: Provides appropriations and allocations to allow for an alternative payment methodology option that is the same as the existing methodology except that rural health clinics may be reimbursed on the basis of 100% of the average of the reasonable costs of providing MaineCare-covered services during calendar years 2016 and 2017 as long as reimbursement is no less than reimbursement received under the prospective payment system.
| GENERAL FUND | 2019-20 | 2020-21 |
|
All Other
|
$739,449 | $1,499,185 |
|
|
|
| GENERAL FUND TOTAL | $739,449 | $1,499,185 |
| FEDERAL EXPENDITURES FUND | 2019-20 | 2020-21 |
|
All Other
|
$1,579,154 | $3,138,020 |
|
|
|
| FEDERAL EXPENDITURES FUND TOTAL | $1,579,154 | $3,138,020 |
| HEALTH AND HUMAN SERVICES, DEPARTMENT OF | ||
| DEPARTMENT TOTALS | 2019-20 | 2020-21 |
|
GENERAL FUND
|
$1,374,645 | $2,787,005 |
|
FEDERAL EXPENDITURES FUND
|
$2,935,669 | $5,833,622 |
|
|
|
| DEPARTMENT TOTAL - ALL FUNDS | $4,310,314 | $8,620,627 |
PART D
Sec. D-1. Transfer. Notwithstanding any provision of law to the contrary, the State Controller shall transfer from the Hospital Tax, Other Special Revenue Funds account in the Department of Health and Human Services $946,925 on or before June 30, 2020 and $946,925 on or before June 30, 2021 to the unappropriated surplus of the General Fund.