MaineHealth Word from Government Affairs - Tuesday, January 30, 2024
Word from Government Affairs. . .
Katie Fullam Harris, Chief Government Affairs Officer
Sarah Calder, Senior Government Affairs Director
Sara Kahn-Troster, Public Policy Associate
This is a regular update on relevant state and federal legislative and regulatory issues. I encourage you to disseminate these updates to your staff. This is an overview of issues, so do not hesitate to contact one of us directly if there is something missing or with any questions, comments, or concerns. Thank you for your time, interest, and input.
State Legislative Update, January 30, 2024
State of the State
The Governor will deliver her State of the State address to the Legislature tonight, and we anticipate that she will also release her proposed Supplemental Budget in the coming days. Please look for an overview of her proposed Supplemental Budget from MaineHealth Government Affairs in the days following the release of her proposal.
LD 1827, “An Act to Prevent Closures and Ensure Sustainability of Nursing Facilities, Private Nonmedical Institutions and Residential Care Facilities by Removing So-called Budget Neutrality”
The Health and Human Services Committee voted in unanimous support of MaineHealth-sponsored language to form a Blue Ribbon Commission charged with making recommendations to update the laws and regulations that are limited access to long-term care in Maine. This language replaced the language in LD 1827, which would have eliminated the so-called MaineCare budget neutrality provisions for nursing facilities in state statute. The Blue Ribbon Commission, however, is tasked with reviewing all laws and rules governing long term care in Maine, including budget neutrality.
The Blue Ribbon Commission language was previously considered by the Committee last year in LD 1785, but, the Committee voted against the bill after the sponsor, Speaker Rachel Talbot Ross, asked the Committee to vote Ought Not to Pass purportedly because the Department of Health and Human Services was opposed. She made this request despite the fact that neither the Governor nor the Department asked her to do so.
As previously reported, Katie Fullam Harris testified in support of the formation of a Blue Ribbon Commission last year and shared that Maine is in a crisis as it relates to access to long term care. For example, on any given day, at least 100 patients are stuck in MaineHealth hospitals awaiting discharge to a long-term care bed.
LD 2009, “An Act to Prevent Abandonment of Children and Adults with Disabilities in Hospitals”
The Health and Human Services voted in unanimous support of a significantly amended version of LD 2009, which directs the Department of Health and Human Services to convene stakeholders, including hospitals, to address the challenge of long-stay youth in hospital Emergency Departments. This amendment was developed in collaboration with Northern Light Health, MaineHealth, and the Maine Hospital Association. The stakeholder group is required to provide recommendations to the Health and Human Services Committee by November 2024.
LD 1205, “An Act Regarding the Scope of Practice of Certified Professional Midwives and Certified Midwives”
Sponsored by MaineHealth, this bill was intended to require midwives to collaborate with physicians to better care for high-risk pregnancies. The bill was strongly opposed by the Certified Professional Midwives and Certified Midwives. At the direction of the Health Coverage, Insurance and Financial Services Committee, the Department of Professional and Financial Regulation convened stakeholders, including inpatient obstetrical providers and Certified Professional Midwives, over the interim to discuss potential opportunities for partnership and collaboration on LD 1205, “An Act Regarding the Scope of Practice of Certified Professional Midwives and Certified Midwives.”
As a result of those meetings, MaineHealth significantly amended LD 1205 to reflect a shared agreement among stakeholders that the data licensed midwives are required to report to the Board of Complementary Health Care Providers in statute is not producing usable data. Unfortunately, after negotiating in good faith with the Maine Association of Certified Professional Midwives and receiving their support of the amended language, the Association decided to oppose the amendment just days before the scheduled public hearing. As a result, the sponsor of LD 1205 requested that the Committee vote against the legislation.
MaineHealth will continue to work with stakeholders, including the midwifery community, to reach a compromise on legislation to be introduced in the 132nd Legislature in January 2025.
LD 2083, “Resolve, to Establish the Stakeholder Group to Ensure Timely Access to Medication Management Across the State”
Kelly Barton, President of Maine Behavioral Healthcare (MBH), testified in strong support of legislation that would prohibit the Department of Public Health from cutting the reimbursement rate for medication management services provided by Nurse Practitioners. The legislation also establishes a stakeholder group to look at the challenges of providing medication management services.
The Department of Health and Human Services, through rate reform, proposed reducing the rate for medication management services provided by Nurse Practitioners, but did not implement the cut. As such, the Office of MaineCare Services submitted testimony in opposition to the legislation stating that it was duplicative and unnecessary as they are not moving forward with the rate reduction. The written testimony also states that the rate for medication management will not be reevaluated until January 2028. It is important to note that MBH lost $4.4 million providing medication management services last year, and services across the state will continue to close without an adequate reimbursement rate.
A Work Session has not been scheduled.
LD 353, “An Act Concerning Substance Use Disorder, Treatment, Recovery, Prevention and Education”
Dr. Leah Bauer, Medical Director of the Addiction Resource Center at Mid Coast-Parkview Health, testified in support of Maine Medical Association-sponsored legislation that codifies in statute the Maine Medical Association’s 1,000 Lives Campaign, which has a goal of preventing 1,000 opioid-related deaths over the next five years. Dr. Bauer also shared with the Health and Human Services Committee the significant gaps in the substance use treatment continuum.
Gordon Smith, Director of Opioid Response for the Governor, testified in opposition to the bill and shared that the data being requested in the amendment would be expensive to retrieve, and, in several cases, is duplicative of data already collected by the Office of Behavioral Health and the Maine Center for Disease Control and Prevention.
A Work Session has not been scheduled.
Federal Legislative Update
The cut to Medicare physician fees went into effect this week. MaineHealth has shared with the Maine delegation the significant gap between Medicare reimbursement for physician services and the cost of providing those services. We will continue to lobby CMS and Congress to reverse this cut, with the goal of doing so in a budget package. The current Continuing Resolution that is funding government runs out on March 1st and March 8th, so there will be a great deal of activity in the coming weeks.
As always, please let us know if you have specific questions or concerns. Katie can be reached at katie.harris@mainehealth.org or (207) 661-7542. Sarah can be reached at sarah.calder@mainehealth.org or 661-7575.
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