Hearings Being Held This Week on Proposed $221 Million Cuts to Health Care Services
Monday, December 12, 2011 8:00 AM
The public will get an opportunity to weigh in on Governor LePage's proposed $221 million in budget cuts to Maine health care this week at three days of public hearings in Augusta. Those who cannot attend can submit written testimony by email or letter. The hearings can be listened to live on the internet at www.maine.gov/legis/ofpr/appr-opriations_committee/audio/index.htm.
The Cuts —
Maine's Bureau of the Budget developed the following summary of the cuts included in Gov. LePage's supplemental budget released on Dec. 6.
• PART B repeals the requirement that MaineCare cover optional services under the MaineCare program for adults for physical and occupational therapy services provided to residents of intermediate care or skilled nursing facilities, subject to federal guidelines and approval.
• PART C repeals provisions requiring copayments for physical therapy services, occupational therapy services, speech therapy services, podiatry services, chiropractic services, optical services and optometric services which are proposed for elimination subject to federal guidelines and approval.
• PART D repeals the requirement that the Department of Health and Human Services administer the program of medical coverage for persons residing in cost reimbursement boarding homes effective July 1, 2012, subject to federal guidelines and approval.
• PART E repeals the requirement that the MaineCare program provide coverage for adult dental services as an optional service under the MaineCare program.
• PART F reduces the maximum income level for parent and caretaker relatives of a child under 18 from 200% FPL to the minimum federal requirement of no less than Standard of Need for AFDC in place in 1996 (approximately 51% FPL). It also eliminates medical coverage for childless adults between the ages of 21 and 64.
• PART G does the following:
- It repeals the elderly low-cost drug program.
- It repeals the requirement that the Department of Health and Human Services provide prescription drug wrap benefits and pay Medicare Part D premiums for certain individuals receiving benefits from the elderly low-cost drug program.
• PART H amends existing legislation in order to authorize the Department of Health and Human Services to eliminate further MaineCare service provisions if necessary "to comply with state balanced budget provisions." Under current law, further cuts are allowed only when necessary to comply with federal law.
• PART I repeals the MaineCare Basic program.
• PART J repeals the provision authorizing the Department of Health and Human Services to provide prescription drug services for MaineCare members through the Elderly Low-Cost Drug Program.
• PART K eliminates the requirement that the MaineCare program cover optional dental services to adults, subject to federal guidelines and approval.
• PART L gives the Department of Health and Human Services the authority to adopt emergency rules to implement any provisions of the bill over which it has specific authority that has not been addressed by some other Part of the bill.
• PART M reduces the reimbursement rate for critical access hospitals from 109% to 105% and strikes the provision that repealed this method of reimbursement effective April 1, 2012.It repeals the provision that requires the Department of Health and Human Services to phase in a system to reimburse critical access hospitals for inpatient services under the MaineCare program based on diagnosis-related groupings. It repeals the provision that requires the Department of Health and Human Services to phase in a system to reimburse critical access hospitals for outpatient services under the MaineCare program based on ambulatory payment classifications.
• PART N eliminates the transfer of $4,500,000 of net slot machine revenue to the Fund for a Healthy Maine for the fiscal year ending June 30, 2013.
More information, including updates through the week, will be available at www.maine.gov/budget/budgetinfo/Dec2011Supplemental.htm.
Public hearings will be held Wednesday, December 14, through Friday, December 16, in Room 228 at the State House on the cuts proposed on December 6 in Gov. LePage's supplemental budget, "An Act to Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2012 and June 30, 2013."
The hearings are scheduled to run until member of the public who have signed up to give oral testimony have done so, or by 9:30 p.m., whichever comes first.
The following is the schedule of the public hearings by broad category:
• Wednesday, December 14, starting at 9 a.m.
Public hearing on budget cuts to elder services, services for developmental disabilities, children's mental health services, Child Medicaid, optional Medicaid coverage to families, foster care/adoption assistance and consumer directed attendant services. Also included would be the portions of the budget related to boarding homes that provide assisted living services and house the elderly and disabled, known as Private Non-Medical Institutions (PNMI) and Targeted Case Management cuts affecting the areas mentioned above.
• Thursday, December 15, starting at 8:30 a.m.
Public hearing on cuts to services for adult mental health, substance abuse, Targeted Case Management services to homeless persons and those with HIV, optional Medicaid coverage for certain 19 and 20 year olds and the Childless Adult Waiver program. Also included would be the portions of the budget related to boarding homes that provide assisted living services and house the elderly and disabled, known as Private Non-Medical Institutions (PNMI) and Targeted Case Management cuts affecting those areas not specifically mentioned.
• Friday, December 16, starting at 8:30 a.m.
Public hearing on cuts to the Fund for a Healthy Maine, The committee will also hear testimony on cutting optional Medicaid services not previously heard, hospital and outpatient reimbursements, DHHS initiatives, money transfers from one fund to another (interfund transfers) and the amount of MaineCare money reimbursed fro medical and pharmacy claims (cycle payments).
This will be the day that reductions for FMAP, the federal matching funds that Maine receives for healthcare, will be addressed. FMAP, the Federal Medical Assistance Percentage, is the amount of money the federal government pays towards MaineCare, the state Medicaid program for low income and disabled people. Medicaid is a partnership between states and the federal government; each state pays part of the cost of its the program and the federal government matches what the state pays in. The portion of costs paid by the federal government is called the "match" or FMAP rate. The FMAP rate for a state can range anywhere from a low of 50% to a high of 83% - the exact match rate changes from year to year and depends on changes in a state's poverty rate relative to all other states. FMAP rates in Maine in mid-2011 were 63.8 percent.