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Amend the resolve by striking out all of section 1 and inserting the following:
‘Sec. 1 Department of Health and Human Services to seek demonstration waiver. Resolved: That the Department of Health and Human Services shall file an application with the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services to request a demonstration waiver under the federal Social Security Act, Section 1115 to develop a program to allow medically tailored food and nutrition interventions to be a reimbursable covered service. The program developed under the waiver is limited to patients being released from a hospital who have a high risk of readmission and have received a doctor's recommendation that certain elements of medically tailored food and nutrition interventions are necessary for the patient's health. Patients being offered medically tailored food and nutrition interventions may receive one meal per day for up to 7 days under the waiver program; and be it further
Sec. 2 Department of Health and Human Services to reimburse for medical nutritional therapy. Resolved: That the Department of Health and Human Services shall provide for reimbursement under the MaineCare program on a pilot basis for 5 years for medical nutritional therapy to treat conditions that include, but are not limited to, being overweight, obesity, hypertension, diabetes, pre-diabetes, disorders of lipid metabolism, HIV infection, unintended weight loss in older adults, chronic kidney disease, gastrointestinal conditions, malnutrition and inappropriate eating habits. For the purposes of this section, "medical nutritional therapy" means a therapeutic approach to treatment of medical conditions and their associated symptoms by use of counseling and a specifically tailored diet devised and monitored by a physician licensed pursuant to the Maine Revised Statutes, Title 32, chapter 36 or 48 or a dietitian licensed pursuant to Title 32, chapter 104 who practices in a hospital, outpatient setting or private office. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A; and be it further’
Amend the resolve in section 2 in the last line (page 1, line 22 in L.D.) by inserting after the following: "interventions" the following: '. The report must also include the number of individuals reimbursed under the MaineCare program under section 2 as well as data relating to improved health status as a result of medical nutritional therapy'
Amend the resolve in section 3 in the last line (page 1, line 28 in L.D.) by striking out the following: "54." and inserting the following: '54; and be it further'
Amend the resolve by inserting after section 3 the following:
‘Sec. 4 Appropriations and allocations. Resolved: That the following appropriations and allocations are made.
 
HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)
 
Medical Care - Payments to Providers 0147
 
Initiative: Provides appropriations and allocations for reimbursement of medically tailored food and nutrition interventions for certain inpatients at high risk of readmission.

GENERAL FUND	2017-18	2018-19	
All Other	$20,365	$27,153	
			
GENERAL FUND TOTAL	$20,365	$27,153	

FEDERAL EXPENDITURES FUND	2017-18	2018-19	
All Other	$36,744	$48,992	
			
FEDERAL EXPENDITURES FUND TOTAL	$36,744	$48,992	

Medical Care - Payments to Providers 0147
 
Initiative: Provides appropriations and allocations for a 5-year pilot program to reimburse for medical nutrition therapy to treat certain conditions.

GENERAL FUND	2017-18	2018-19	
All Other	$15,640	$20,854	
			
GENERAL FUND TOTAL	$15,640	$20,854	

FEDERAL EXPENDITURES FUND	2017-18	2018-19	
All Other	$28,220	$37,626	
			
FEDERAL EXPENDITURES FUND TOTAL	$28,220	$37,626	

Office of MaineCare Services 0129
 
Initiative: Provides appropriations and allocations for development and testing of changes to the Maine Integrated Health Management System claims processing system.

GENERAL FUND	2017-18	2018-19	
All Other	$74,580	$0	
			
GENERAL FUND TOTAL	$74,580	$0	

FEDERAL EXPENDITURES FUND	2017-18	2018-19	
All Other	$223,740	$0	
			
FEDERAL EXPENDITURES FUND TOTAL	$223,740	$0	

HEALTH AND HUMAN SERVICES, DEPARTMENT OF (FORMERLY DHS)			
DEPARTMENT TOTALS	2017-18	2018-19	
			
GENERAL FUND	$110,585	$48,007	
FEDERAL EXPENDITURES FUND	$288,704	$86,618	
			
DEPARTMENT TOTAL - ALL FUNDS	$399,289	$134,625	
 
’
Amend the resolve by relettering or renumbering any nonconsecutive Part letter or section number to read consecutively.
 
SUMMARY
This amendment, which is the majority report of the committee, narrows the medically tailored and nutrition interventions demonstration waiver program to individuals who are being released from the hospital, are at risk of readmission and have received a doctor's recommendation that certain elements of nutrition or foods are necessary for the patient's health. Patients offered medically tailored food and nutrition interventions may receive one meal per day for up to 7 days. The amendment also requires the Department of Health and Human Services to reimburse under the MaineCare program for medical nutritional therapy for certain conditions on a pilot basis. The Department of Health and Human Services must report annually for 5 years on the medically tailored food and nutritional interventions demonstration program and the medical nutritional therapy pilot program.
The amendment also adds an appropriations and allocations section.
FISCAL NOTE REQUIRED
(See attached)