Notice of MaineCare Reimbursement Methodology Change, MaineCare Benefits Manual, Section 45, Hospital Services

Date posted:

Attachment(s):

Notice of MaineCare Reimbursement Methodology Change

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

SERVICES INCLUDED:  Chapter 101, MaineCare Benefits Manual, Section 45, Hospital Services

NATURE OF PROPOSED CHANGES: Effective November 2024 the Department plans to amend existing hospital supplemental pool payment amounts to the following:

 

Total Acute Care Hospital (ACH) Supplemental Pool: Up to $85,815,190

Inpatient ACH Supplemental Pool: Up to $47,638,238

Outpatient ACH Supplemental Pool: Up to $38,176,952

 

*Total Critical Access Hospital (CAH) Supplemental Pool: Up to $6,396,901

Inpatient CAH Supplemental Pool: Up to $6,396,901

 

*As a reminder, the Department previously communicated that it will eliminate, effective December 31, 2024, Critical Access Hospital supplemental pool payments.

REASON FOR PROPOSED CHANGES: All changes are pursuant to Maine P.L. 2023, ch. 643, An Act to Make Supplemental Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and to Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2024 and June 30, 2025.

ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will result in a decrease of $4,252,888 in federal fiscal year 2025 which includes $3,084,234 in federal funds and $1,204,654 in state funds.

ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES:  The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926. The Department will hold a hearing for the proposed rulemaking and will be publishing a notice which includes information on the hearing date and location.

CONTACT INFORMATION FOR RECEIPT OF COMMENTS:   Kristin Merrill  

                                                                                                         Kristin.Merrill@maine.gov

AGENCY NAME:                                              Office of MaineCare Services

ADDRESS:                                                         109 Capitol Street, 11 State House Station

                                                                            Augusta, Maine 04333-0011

TELEPHONE:(207) 624-4006 FAX: (207) 287-6106

                                                               TTY: 711 Maine Relay (Deaf or Hard of Hearing)

See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.

State Plan Amendment

Office: MaineCare Services

Email: Kristin.Merrill@maine.gov

Comment deadline:

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