Maine Seeks Federal Court Review of Medicaid State Plan Amendment

September 4, 2012

AUGUSTA ? Attorney General William J. Schneider issued the following statement today:

?The State of Maine, through its Department of Health and Human Services, submitted a proposed State Plan Amendment (SPA) to the United States Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS) on August 1, 2012. Maine proposed to amend its Medicaid State Plan to make specific MaineCare eligibility changes to three groups consistent with legislative directives effective October 1, 2012.

?Maine?s standards in these areas still remain at or greater than the federal minimums with the proposed MaineCare eligibility changes.

?Maine asked CMS to review the SPA on an expedited basis and to approve the SPA by September 1, 2012. Maine explained to CMS that an expedited decision was needed so that Maine could achieve its budget savings as directed by the Legislature and achieve a balanced budget as required by the Maine Constitution.

?Although Maine explained to CMS that it preferred not to resort to the courts, Maine made it clear to CMS that Maine would suffer irreparable injury absent CMS?s expeditious review of the SPA or CMS?s commitment to pay Maine for its costs while the SPA was pending, which CMS could later recoup by adjusting Medicaid reimbursements to Maine.

?In a letter dated August 31, 2012 CMS indicated that it will not issue an expedited decision on Maine?s SPA and did not address paying Maine?s costs while the SPA is pending before CMS, foreclosing the possibility of advancing resolution of this issue without resort to litigation.

?The failure of CMS to take action in consideration of the State?s critical time constraints is in effect a denial Maine?s proposed SPA. Given the response from CMS, Maine has no choice but to present this matter to the United States Court of Appeals for the First Circuit. Maine is filing a Petition for Review of CMS?s failure to act upon Maine?s request for the SPA. Maine is simultaneously filing a Motion for Injunctive Relief asking the First Circuit to: (1) order CMS to approve the SPA, or (2) order CMS to pay Maine?s share for coverage of these three groups over and above the amounts Maine would pay if the SPA was approved on or before October 1, 2012.

?We anticipate that the First Circuit will resolve this matter expeditiously.?

Supporting documents

Petition For Review

Motion For Injunctive Relief