§3174-Q. Medicaid stability
1. Legislative authorization. Except as provided in subsection 2, the department, in its administration of the Medicaid program and the federal State Children's Health Insurance Program or any successor program, shall obtain authorization from the Legislature by proper enactment of law before:
A. Implementing changes in eligibility for the Medicaid program that are reasonably likely to cause a decrease in excess of 10% in the percentages of enrollment in any covered group during any year or over any 5-year period unless individuals losing eligibility in a covered group are eligible in any other covered group with substantially similar or greater coverage; [PL 2019, c. 266, §1 (NEW).]
B. Eliminating, having the effect of significantly limiting or significantly reducing eligibility for a category of service covered under the Medicaid program or the federal State Children's Health Insurance Program without comparable service provided in its place; [PL 2019, c. 266, §1 (NEW).]
C. Accepting a block grant or any other fundamental alteration in the method of federal funding for the Medicaid program that could result in a substantial decrease in total funding for the program; or [PL 2019, c. 266, §1 (NEW).]
D. Applying for or amending a waiver, including a waiver pursuant to Section 1115 of the Social Security Act, or adopting a state plan amendment that could significantly reduce the scope of services of or eligibility for the Medicaid program or the federal State Children's Health Insurance Program. [PL 2019, c. 266, §1 (NEW).]
[PL 2019, c. 266, §1 (RPR).]
2. Exceptions in the event of federal law changes. If an action must be taken by the department to comply with federal law and obtaining authorization from the Legislature cannot be achieved timely to comply with federal requirements, the department may act only to the extent necessary to achieve compliance with federal law, pending further action of the Legislature under this section.
[PL 2019, c. 266, §1 (RPR).]
3. Failure to comply. A person may not be denied eligibility for the Medicaid program or the federal State Children's Health Insurance Program as the result of a change to those programs as described in subsections 1 and 2 if the department failed to comply with this section.
[PL 2019, c. 266, §1 (NEW).]
SECTION HISTORY
PL 1995, c. 696, §B2 (NEW). PL 2009, c. 571, Pt. PPP, §1 (AMD). PL 2019, c. 266, §1 (RPR).
Structure Maine Revised Statutes
Subtitle 3: INCOME SUPPLEMENTATION
Chapter 855: AID TO NEEDY PERSONS
22 §3172-A. Mental Health and Mental Retardation Improvement Fund (REPEALED)
22 §3172-B. Moneys received; credit to General Fund; unencumbered balance (REPEALED)
22 §3173. Powers and duties of department
22 §3173-A. Reimbursement for therapy; intermediate care facilities and skilled nursing facilities
22 §3173-B. Medically needy program; certain individuals in intermediate care facilities
22 §3173-D. Reimbursement for substance use disorder treatment
22 §3173-E. Treatment of joint bank accounts in Medicaid eligibility determinations
22 §3173-F. Charging or increasing premiums
22 §3173-G. Medicaid coverage for reproductive health care and family planning services
22 §3173-H. Services delivered through telehealth
22 §3173-I. Maine Telehealth and Telemonitoring Advisory Group
22 §3174-A. Medical coverage program for certain boarding home residents
22 §3174-C. Coverage for inpatient hospital mental disease treatment services
22 §3174-E. Interim assistance agreement
22 §3174-F. Coverage for adult dental services
22 §3174-H. Availability of income between married couples in determination of eligibility
22 §3174-I. Medicaid eligibility determinations for applicants to nursing homes
22 §3174-J. Medicaid drug formulary (REPEALED)
22 §3174-K. Counseling for certain children
22 §3174-L. Parity among counselors
22 §3174-M. Medicaid drug formulary
22 §3174-N. Authorization to pursue federal waivers to develop Medicaid managed-care program
22 §3174-P. Prescription processing service fee (REPEALED)
22 §3174-Q. Medicaid stability
22 §3174-R. Medicaid drug rebate program
22 §3174-T. Cub Care program (REALLOCATED FROM TITLE 22, SECTION 3174-R)
22 §3174-U. Medicaid reimbursement for dental services
22 §3174-V. Federally qualified health center reimbursements
22 §3174-W. Procedure for home health care changes (REALLOCATED FROM TITLE 22, SECTION 3174-U)
22 §3174-X. Contracted ombudsman services
22 §3174-Y. Prior authorization in Medicaid program
22 §3174-Z. Private, nonmedical and board and care institutions
22 §3174-BB. Enrollment periods
22 §3174-CC. Medicaid eligibility during incarceration
22 §3174-DD. Dirigo health coverage
22 §3174-EE. Mail order drugs (REALLOCATED FROM TITLE 22, SECTION 3174-AA)
22 §3174-GG. Long-term Care Partnership Program
22 §3174-HH. Coordination of services
22 §3174-II. Relationship to federal Medicare program
22 §3174-KK. MaineCare Stabilization Fund (REALLOCATED FROM TITLE 22, SECTION 3174-II)
22 §3174-LL. Inpatient services reimbursement based on diagnosis-related groups
22 §3174-QQ. Care for children with life-threatening conditions
22 §3174-RR. Dental hygienist reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-QQ)
22 §3174-SS. Calculation of 24 months (REPEALED)
22 §3174-TT. Limitation on reimbursement for opioids (REPEALED)
22 §3174-UU. Reimbursement for opioid drugs for the treatment of pain
22 §3174-WW. Tobacco cessation
22 §3174-XX. Dental therapy reimbursement
22 §3174-YY. State educational Medicaid officer
22 §3174-ZZ. Reimbursement for hearing aids
22 §3174-CCC. Chiropractic services reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-AAA)
22 §3174-DDD. Coverage for conversion therapy (REALLOCATED FROM TITLE 22, SECTION 3174-BBB)
22 §3174-EEE. Prior authorization of treatment for opioid use disorder
22 §3174-FFF. State-funded medical program for noncitizens
22 §3174-GGG. Palliative care reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-FFF)
22 §3174-HHH. Ostomy equipment reimbursement (REALLOCATED FROM TITLE 22, SECTION 3174-FFF)
22 §3174-III. Reimbursement for donor breast milk
22 §3175. Acceptance of federal provisions
22 §3175-A. Delinquent nursing home taxes to be withheld from Medicaid payments
22 §3175-B. Delinquent residential treatment facility taxes to be withheld from Medicaid payments
22 §3175-C. Delinquent hospital taxes to be withheld from Medicaid payments
22 §3175-D. Nursing facility depreciation
22 §3176. Treasurer of State as agent
22 §3178. Payment to conservator or guardian
22 §3179. Change of circumstances
22 §3180. Inalienability of aid
22 §3182. Fraudulent representations; penalty
22 §3184. Recovery of illegal payments
22 §3185. Medical expenses for catastrophic illness
22 §3186. Medical and social services referral service
22 §3187. Principles of reimbursement; rules
22 §3188. Maine Managed Care Insurance Plan Demonstration for uninsured individuals
22 §3189. The Maine Health Program (REPEALED)
22 §3189-A. Advisory Board to Privatize the Maine Health Program (REPEALED)
22 §3190. Community Health Program grants (REPEALED)
22 §3192. Community Health Access Program
22 §3193. Affordable Health Care Fund (REALLOCATED FROM TITLE 22, SECTION 3192)
22 §3194. Report on cost of dispensing medication
22 §3195. Compensation for care provided to persons with intellectual disabilities or autism
22 §3196. Coverage for non-Medicaid services to MaineCare members