An Act to Provide Per Diem Payments for MaineCare Residents of the Maine Veterans' Homes

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132nd MAINE LEGISLATURE
FIRST REGULAR SESSION-2025
Legislative Document No. 182
H.P. 115 House of Representatives, January 14, 2025
An Act to Require the Department of Health and Human Services to
Establish MaineCare Reimbursement Rates for the Maine Veterans'
Homes on a Per Resident Basis
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative SUPICA of Bangor.

Page 1 - 132LR0305(01)
1Be it enacted by the People of the State of Maine as follows:
2Sec. 1. 22 MRSA §1708-A is enacted to read:
3§1708-A. Reimbursement to Maine Veterans' Homes
4 Services provided by a veterans' facility must be reimbursed by the MaineCare program
5 at rates established by the department pursuant to this section. This section applies to all
6 funds, including federal funds, paid by an agency of the State to a veterans' facility for
7 resident care.
81. Definitions. As used in this section, unless the context otherwise indicates, the
9 following terms have the following meanings.
10 A. "Multilevel health care facility" has the same meaning as in section 7852, subsection
11 10-A.
12 B. "Nursing home" has the same meaning as in section 1812-A.
13 C. "Residential care facility" has the same meaning as in section 7852, subsection 14.
14 D. "Veterans' facility" means a nursing home, residential care facility or multilevel
15 health care facility that is operated by the Maine Veterans' Homes at any location
16 required under Title 37-B, section 601, subsection 2.
172. Per resident basis. Veterans' facilities must be reimbursed on a per resident daily
18 rate basis for services to residents covered under the MaineCare program. Different rates
19 may be established for services equivalent to those provided by nursing homes, residential
20 care facilities and multilevel health care facilities.
213. Rate calculations. Rate calculations under this section must result in
22 reimbursement of the portion of the total MaineCare allowable cost of operating each
23 veterans' facility attributable to the provision of services to residents who receive
24 MaineCare benefits. Different rates may be established for services equivalent to those
25 provided by nursing homes, residential care facilities and multilevel health care facilities.
264. Annual adjustments for inflation. Rates established pursuant to this section must
27 be adjusted annually to reflect projected inflation for the year to which the rates will apply.
285. Other states' data; limitation. The department may use data from other states'
29 veterans' home programs and appropriate price indices to establish the rates required in this
30 section, as long as the application of data from other states' veterans' home programs and
31 price indices does not reduce reimbursement below the portion of the total MaineCare
32 allowable cost as described in subsection 3.
336. Use of 3rd party. The department may contract with a 3rd party to derive or review
34 the rates established under this section.
35SUMMARY
36 This bill requires the Department of Health and Human Services to establish
37 reimbursement rates for Maine Veterans' Homes services covered by the MaineCare
38 program. It requires the MaineCare program to reimburse veterans' facilities for covered
39 services on a per resident daily rate basis that will reimburse the portion of the total
40 MaineCare allowable cost of operating each veterans' facility attributable to the provision
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41 of services to residents who receive MaineCare benefits. It requires the department to index
42 the rates to inflation annually and authorizes the department to contract with a 3rd party to
43 derive or review the rates.
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