Bill > LD2177

This bill updates how MaineCare, the state's Medicaid program, reimburses healthcare providers by modifying existing laws related to its payment system. Specifically, it changes how nursing homes are reimbursed, directing the Department of Health and Human Services to establish rates based on a new section of law (§3173-J) rather than the previous subsection. It also repeals a section of law related to nursing facility reimbursement and significantly amends §3173-J, which governs the rate-setting system for MaineCare-covered services. The updated §3173-J clarifies definitions for terms like "payment model" and "reimbursement methodology," establishes principles for developing and maintaining sustainable, efficient, and value-oriented reimbursement, and outlines processes for rate determination, including regular benchmarking against other payers and conducting rate studies. It also details how rates should be updated to account for inflation and changes in costs, with a focus on using specific inflation indices and aligning with minimum wage increases for essential support workers. The bill also modifies requirements for rulemaking, the role of the MaineCare Rate Reform Expert Technical Advisory Panel, and the MaineCare Advisory Committee, and requires the department to maintain a publicly accessible index of MaineCare rates.

Health and Social Services

https://legislature.maine.gov/legis/bills/display_ps.asp?LD=2177&snum=132