LePage administration, providers continue to haggle over mental health care rates

Good morning from Augusta. Pffft. We’re not in Augusta. All state offices and the Legislature are closed today because, well, it’d take a military extraction team to remove us from our homes at this point. It’s snowin’.

Regardless, the Daily Brief soldiers on. We hope you are all safe and warm. Here’s your soundtrack.

With not much to look at today other than white, let’s take a glance back to Friday, which turned into a busier day than we planned when Gov. Paul LePage called reporters to his office for the first time in many, many months. Elsewhere at the State House, lawmakers on the Legislature’s Health and Human Services Committee were delving into a new rate study of how much the state pays service providers for mentally ill Mainers who rely on publicly funded MaineCare health insurance.

The study was triggered in February 2016 when the Department of Health and Human Services proposed a slew of new payment rates for services. Providers of community mental health services said the net effect on them would be devastating.

For example, the rate-change proposal calls for the state’s MaineCare program to pay more for some forms of community-based treatment programs — especially those run by licenses psychiatrists — by 36 percent or more. On the other hand, the proposed rules would put a new restriction on providers that they limit overhead costs and keep close tabs on staff productivity. According to an executive summary of the rate study, providers should limit overhead costs to 33 percent of total costs when currently, many are operating with overhead of 35 percent to 45 percent.

Health and Human Services Commissioner Mary Mayhew has said that the rate review and proposed changes are part of the department’s efforts to ensure that taxpayer funding is used efficiently and that taxpayer-funded services cost what they should. This process began as a compromise in the biennial budget bill that was enacted in June 2015, which called for the rate study of sections 13, 17, 28 and 65 of a sprawling document known as the MaineCare Benefits Manual.

That’s just the tip of the iceberg. If you want to read more, here’s the executive summary, here’s the full study and here’s a synopsis the Arizona consulting firm provided of the provider comments. That ought to keep you busy, even through this blizzpocalypse.

Providers say the rate review is Maine’s part of a national move among states to reduce government payments for mental health services but Mayhew says it’s about a years-long effort to find new efficiencies.

“We have begun to take seriously the responsibility of evaluating the rates of reimbursement that are being paid,” said Mayhew to the Bangor Daily News last year.

Now that the rate study is final, the department will start a formal rulemaking process that includes more chances for the public to weigh in. Stay tuned on this one. — Christopher Cousins


Quick hits

  • Why was a college student ousted from a budget hearing?: The Legislature’s Appropriations Committee was the scene of a minor kerfuffle on Friday when University of Maine student Mary Manley of Manchester was kicked out of a hearing on LePage’s budget proposal by Sen. James Hamper, R-Oxford, the committee’s co-chairman. Manley was there to testify against LePage’s proposed delay of the voter-approved surtax on high-income earners to fund education. The Portland Press Herald reported that Hamper ejected Manley after “some audience members appeared to cheer and support statements by another witness who was urging lawmakers not to overturn the ballot question,” with the senator saying, “I won’t take faces and I won’t take the comments back here, got it? You’re an example. Out.” In a post for the progressive Maine People’s Alliance’s news arm, Manley said her “face” was “just my shocked expression as a result of his screaming at those in attendance.” Jim Cyr, a spokesman for Senate President Mike Thibodeau, R-Winterport, said activists “did not respect the committee rules” and Mainers should be able to share testimony “without interruption or reaction from the audience.”
  • News from two Republican shadow campaigns: Former Maine Republican Party Chairman Rick Bennett, who is considering a run for governor in 2018, was in Aroostook County on Friday “talking to local leaders in business and government,” according to his daughter, Abby. As reporter Duke Harrington noted on Facebook, “Now, for what reason would somebody who’s no longer GOP chairman make such a trip?” Indeed. And on Friday, state Sen. Eric Brakey of Auburn — expected to run against independent U.S. Sen. Angus King next year — will be in Washington, D.C., speaking alongside U.S. Rep. Thomas Massie, R-Kentucky, at a Young Americans for Liberty event.
  • And two Republican state representatives have filed for re-election in 2018: That’s the third-term conservative bomb-thrower Lawrence Lockman of Amherst and freshman Gina Mason of Lisbon Falls, the mother of Senate Majority Leader Garrett Mason, himself a potential Republican gubernatorial candidate.
  • Stay safe out there: The Maine Emergency Management Agency is taking this storm seriously and has already consulted today with the National Weather Services, the Department of Transportation, the Maine Turnpike Authority, the Maine State Police and electric and communications facilities. With more than two feet of snow expected in some areas, this storm is no joke. Monitor MEMA’s Facebook page by clicking here. Watch the latest weather forecast from the National Weather Services Gray and Caribou bureaus by clicking here and here. And finally, read more about what MEMA is up today by clicking here. If this is all just causing you a stress headache, click here. — Michael Shepherd and Christopher Cousins

Reading list


Do not try this at home

A television program that my 6-year-old and I enjoy is called Outrageous Acts of Science, which includes interesting video clips from the internet and descriptions of the science behind them. Sometimes I wonder about our viewing choices when the show describes how to cause explosions or how to jump from a 40-foot platform and survive.

On Sunday there was a fun clip: Some guys had dug a hole in the ground, inserted a steel barrel in it upside down, filled with barrel with explosive gas and ignited it. KABOOOM, and the barrell flew 50 feet in the air.

Just as the 6-year-old was saying, “Daddy can we try that at…” the announcer on the show said “DON’T TRY THIS AT HOME.”

“Dang it!” said the kid. “Well, can we go to someone else’s house and try it?”

Hmmm. That might just work. – Christopher Cousins

With tips, pitches, questions or feedback, email us at politics@bangordailynews.com. If you’re reading The Daily Brief on the BDN’s website or were forwarded it, click here to get Maine’s only newsletter on state politics and policy delivered via email every weekday morning.

Christopher Cousins

About Christopher Cousins

Christopher Cousins has worked as a journalist in Maine for more than 15 years and covered state government for numerous media organizations before joining the Bangor Daily News in 2009.