Resolve, Directing the Department of Health and Human Services to Timely Provide Interim Settlement Payments to Long-term Care Facilities
Summary
LD 1345 is a resolve directing the Department of Health and Human Services (DHHS) to make interim settlement payments more quickly to long-term care providers. It requires DHHS to pay nursing facilities by October 31, 2025 an interim cost settlement amount equal to 75% of settlement amounts shown on as-filed cost reports that have been submitted but not yet audited, with certain offsets for amounts already paid under prior law. It also requires DHHS to adopt any needed rule changes by December 1, 2025 if existing rules have not yet been amended to match prior legislative direction.
The bill also extends similar treatment to private nonmedical institutions reimbursed as residential care facilities. DHHS would have to pay those facilities by October 1, 2025 an interim settlement amount equal to 75% of the settlement due on as-filed cost reports not yet audited, and by December 1, 2025 amend reimbursement rules so that at least 75% of the settlement due is reimbursed within 90 days of receiving each cost report. The resolve further directs DHHS to make conforming rule changes in related MaineCare reimbursement rules and authorizes emergency rulemaking, without requiring the usual factual findings of emergency, to implement the measure.
The bill’s impact is primarily on DHHS reimbursement administration and on the cash flow of nursing facilities and residential care providers. It does not create a new benefit program, but instead accelerates and clarifies payment timing for existing settlement obligations, reinforcing prior legislative requirements and tying them to specific deadlines. It would affect the department’s reimbursement rules under the MaineCare Benefits Manual and the rules governing residential care facility room-and-board costs.
General sentiment around the bill appears supportive of long-term care providers, with the measure framed as a timely-payment and compliance resolve rather than a policy overhaul. The bill is sponsored by Senator Stewart and cosponsored by other legislators from both chambers and parties, suggesting some bipartisan interest in addressing delayed settlements. No committee transcript or vote record was provided, so there is no documented opposition in the supplied materials.
The main point of contention, based on the text itself, is likely administrative and fiscal rather than ideological: whether DHHS can meet the accelerated deadlines within existing resources and whether the department should be required to issue emergency rules and retroactive payment adjustments. Another possible issue is the scope of the 75% interim payment requirement and how it interacts with prior payments and unresolved audits, especially for facilities with older cost reports still awaiting settlement.
Impact
LD 1345 would require DHHS to accelerate interim settlement payments to nursing facilities and private nonmedical institutions/residential care facilities, paying 75% of as-filed settlement amounts by specified dates and within 90 days for future cost reports once rules are amended. It would also compel DHHS to update reimbursement rules in Chapter 115 and related MaineCare provisions, and to use emergency rulemaking if needed. The resolve reinforces and clarifies existing reimbursement obligations under prior legislation, affecting DHHS administrative practice and the timing of payments to long-term care providers.
Sentiment
The available text suggests a generally favorable sentiment toward the bill, especially among long-term care providers and the legislators sponsoring it. The measure is presented as a compliance and timeliness fix to ensure facilities receive settlement payments sooner, and the bipartisan cosponsorship indicates broad interest in addressing the issue. Because no committee discussion or vote history was provided, there is no recorded opposition or formal debate in the supplied materials.
Contention
The likely areas of contention are implementation and fiscal administration. DHHS may face pressure over whether it can meet the payment deadlines and rulemaking requirements within existing resources, and the bill explicitly allows emergency rules without the usual emergency findings, which could raise procedural concerns. Facilities and advocates are likely to support the accelerated payments, while any resistance would most likely come from concerns about agency workload, budget impact, audit timing, and how to handle settlements that are still pending review.
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