LAW WITHOUT
GOVERNOR'S CHAPTER
SIGNATURE
118
JULY 15, 2021 RESOLVES
STATE OF MAINE
_____
IN THE YEAR OF OUR LORD
TWO THOUSAND TWENTY-ONE
_____
H.P. 1085 - L.D. 1469
Resolve, To Provide Add-on Payments for Ambulance Services Reimbursed
by the MaineCare Program and To Increase Reimbursement Rates for
Physical Therapy under the MaineCare Program
Sec. 1. Department of Health and Human Services to apply Medicare add-
ons to MaineCare rates for ambulance services. Resolved: That, no later than
October 1, 2021, the Department of Health and Human Services shall amend its rules in
Chapter 101: MaineCare Benefits Manual, Chapter III, Section 5, Ambulance Services, to
provide additional add-on supplements for ambulance services that are equivalent to
payments required under Medicare ambulance services under 42 United States Code,
Section 1395m(l). The department shall use the same geographic zip codes applicable for
rural, urban and super rural payments as established by 42 United States Code, Section
1395m(l) and related federal rules. 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. 2. Cost-based reimbursement work group for ambulance services.
Resolved: That the Department of Health and Human Services shall convene a work
group to consider the feasibility and cost of implementing cost-based reimbursement for
ambulance services provided to MaineCare members. The work group must include
representatives of the Emergency Medical Services' Board within the Department of Public
Safety, the Maine Ambulance Association and ambulance providers. The department shall
submit a report, with recommendations, to the Joint Standing Committee on Health and
Human Services no later than January 15, 2022. The committee is authorized to report out
legislation related to the recommendations.
Sec. 3. Department of Health and Human Services to increase MaineCare
reimbursement rates for physical therapy. Resolved: That, no later than October
1, 2021, the Department of Health and Human Services shall amend its rules in Chapter
101: MaineCare Benefits Manual, Chapter III, Section 85, Physical Therapy Services, to
increase reimbursement rates for physical therapy services to no less than 57% 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, 2021. Rules adopted pursuant to this section are routine
Page 1 - 130LR0887(05)
technical rules as defined in the Maine Revised Statutes, Title 5, chapter 375, subchapter
2-A.
Sec. 4. 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 for the Department of Health and Human Services to amend
the rules under Chapter 101: MaineCare Benefits Manual, Chapter III, Section 5,
Ambulance Services, to provide additional add-on supplements that are equivalent to
payments required under Medicare ambulance services under 42 United States Code,
Section 1395m(l).
GENERAL FUND 2021-22 2022-23
All Other $243,828 $327,814
__________ __________
GENERAL FUND TOTAL $243,828 $327,814
FEDERAL EXPENDITURES FUND 2021-22 2022-23
All Other $477,856 $634,432
__________ __________
FEDERAL EXPENDITURES FUND TOTAL $477,856 $634,432
Medical Care - Payments to Providers 0147
Initiative: Provides funding to set the reimbursement rates for physical therapy services
under the Department of Health and Human Services rule Chapter 101: MaineCare Benefits
Manual, Chapter III, Section 85 at 57% of the federal Medicare reimbursement rate as long
as the rate is no lower than the rate in effect on January 1, 2021.
GENERAL FUND 2021-22 2022-23
All Other $400,951 $539,056
__________ __________
GENERAL FUND TOTAL $400,951 $539,056
FEDERAL EXPENDITURES FUND 2021-22 2022-23
All Other $712,802 $945,948
__________ __________
FEDERAL EXPENDITURES FUND TOTAL $712,802 $945,948
HEALTH AND HUMAN SERVICES,
DEPARTMENT OF
DEPARTMENT TOTALS 2021-22 2022-23
GENERAL FUND $644,779 $866,870
FEDERAL EXPENDITURES FUND $1,190,658 $1,580,380
__________ __________
Page 2 - 130LR0887(05)
DEPARTMENT TOTAL - ALL FUNDS $1,835,437 $2,447,250
Page 3 - 130LR0887(05)