MDI Hospital Advocacy

Rural healthcare nationally is experiencing unprecedented challenges that jeopardize access and services

1. Workforce shortages
2. High cost of prescription drugs
3. Underpayment by Medicare and Medicaid
4. Rural health organizations are smaller, so patients are transferred to larger hospitals nearby for acute care

Rural hospitals and health systems serve small and underserved communities, filling a void of immediate and high-quality care

• Preserve Non-Profit status and avoid PILOT or other taxation
• Demonstrate Community Benefit – FY 2024 over $13M in direct benefit to MDI and beyond

The 340B Drug Discount Program was created in 1992 and provides eligible hospitals with access to discounted drug prices for their patients receiving outpatient hospital services.

Eligible hospitals include those that provide a disproportionate amount of care to low-income patients and Critical Access Hospitals

This program produces significant savings for safety net providers, between 20-50% of a drug’s cost

27 Maine hospitals qualify and receive a collective benefit of $282 million a year.

Eliminating 340B would have a devastating impact on the financial health of these organizations.

Federal and State Advocacy Priority

• MHA advocating for the protection of the 340B Program
• It’s about safeguarding healthcare access for our community.
• It’s about ensuring your neighbors, friends, and family members can continue receiving the care they need close to home.
• It’s about ensuring access to underfunded vital services and programs.
  • Behavioral Health
  • Maternal Health
  • Community Education
  • Care Management, Palliative Care, and Cancer Navigation
  • Emergency Services
  • Primary Care

Introduce State Legislation for 340B Protections

• MHA has submitted legislation that has been successful in 13 of 14 states.
• This is meant to curb discriminatory actions by pharmaceutical companies that do not comply with federal regulations.

How does this benefit MDI Hospital?

• Safety-Net Hospital & Critical Access Hospital
• Defined purchase savings
• Contract Pharmacy Savings and Sustainability and fee revenue – Partners
  • Carroll’s
  • Walgreens
  • Hannaford
  • Walmart

This bill provides a municipality the power to limit the amount of a property tax exemption given to a nonprofit institution or organization when the municipality determines by vote that such an exemption would be detrimental to the residents of that municipality.

MDI Hospital provides millions of dollars of free and uncompensated care to the community each year. Like many other nonprofit institutions, we operate on a very tight budget and to open the possibility of implementing a tax would not reduce the amount of free and uncompensated care we give that is necessary to the community, it would severely hinder the hospital’s ability to expand and sustain other vital services that the community needs. 

Medicare Advantage Plans (Part C)

Ensuring Cost-based Reimbursement for CAHs from MA Plans

Background: CAHs have a special statutory payment designation to support their role in rural healthcare.

• The growth of MA plans in rural areas has eroded this financial protection.
• Negotiations with MA plans often result in below-cost payment terms, administrative burdens, and delays in approving and paying for patient care.

AHA’s Position: The AHA supports legislation to ensure that CAHs receive cost-based reimbursement for services provided to MA patients, aligning MA payments with traditional Medicare standards.

Advocating for Prompt Payment and Prior Authorization Reforms:

Prompt Payment:

• AHA advocates for policies that ensure timely payments from insurers for medically necessary, covered healthcare services.
• Includes increasing oversight and establishing stringent standards to address insurer tactics that delay or deny payments to healthcare providers.

Prior Authorization:

• AHA seeks to hold commercial health insurers accountable for ensuring patients have timely access to care.
• Involves reducing excessive use of prior authorization, ensuring expeditious decisions, and eliminating inappropriate denials for services that should be covered.
• Streamlining these processes aims to reduce administrative burdens on healthcare providers.

Kids Stuck in Emergency Departments

• Advocate for payment while awaiting placement for Maine DHHS

Adults in Need of Long Term Care Stuck in Hospitals

• Amend 45-Day Maine Care eligibility requirements
• Amend the 60-mile radius requirement for placement
• Amend Adult Protective Services guardianship requirement of prior placement acceptance as a condition of prior authorization

MaineCare Provider Enrollment Credentialing

• Amend requirements for approving providers to care for MaineCare beneficiaries with a turnaround time of 48 hours.
• Accept multiple provider credentialling applications from a single organization rather than one at a time.

Repeal Free COVID Vaccination & Testing Requirements for Uninsured

• Allow providers to charge for services related to the testing and provision for COVID-19, including the administration of vaccinations that are not government supplied

Senator Nicole Grohoski (D-Hancock) Senate District 7
(207) 358-8333

Nicole.Grohoski@legislature.maine.gov

District: Bar Harbor, Blue Hill, Brooklin, Brooksville, Castine, Cranberry Isles, Deer Isle, Ellsworth, Frenchboro, Lamoine, Marshall Island UT, Mount Desert, Orland; Penobscot, Sedgwick, Southwest Harbor, Stonington, Surry, Swan’s Island, Tremont, Trenton, Verona Island, Isle au Haut

Billy Bob Faulkingham (R-Winter Harbor) House District 12
(207) 460-6967

William.Faulkingham@legislature.maine.gov

District: Franklin, Gouldsboro, Hancock, Sorrento, Sullivan, Winter Harbor, Steuben

Russell P. White (R-Ellsworth) House District 13

(207) 460-6359

Russell.White@legislature.maine.gov

District: Fletchers Landing Township. Waltham, Ellsworth, Central Hancock

Gary Friedmann (D-Bar Harbor) House District 14

(207) 460-7362

Gary.Friedmann@legislature.maine.gov
District: Bar Harbor, Cranberry Isles, Lamoine, Mount Desert

Holly Rae Eaton (D-Deer Isle) House District 15

(207) 610-9281

Holly.Eaton@legislature.maine.gov

District: Brooklin, Deer Isle, Frenchboro, Marshall Island, Southwest Habor, Stonington, Swan’s Island, Tremont, Eagle Island Township, Isle au Haut, Vinalhaven

Nina Azella Milliken (D-Blue Hill) House District 16

(207) 412-8828
Nina.Milliken@legislature.maine.gov

District: Blue Hill, Brooksville, Castine, Sedgwick, Surry, Trenton

Senator Susan Collins – (R)
Bangor Office: P.O. Box 655, 202 Harlow Street, Room 204,
Bangor, ME 04402
Bangor Phone: (207) 945-0417
DC Office: 413 Dirksen Senate Office Building,
Washington, DC 20510
DC Phone: (202) 224-2523
Email: link available at: http://collins.senate.gov/

Senator Angus King – (I)
Bangor Office: The Margaret Chase Smith Federal Building
202 Harlow St., Suite 214
Bangor, Maine 04401
Phone: (207) 945-0432
DC Office: 188 Russell Senate Office Building
Washington, DC 20510
DC Phone: (202) 224-5344
Email: link available at: http://www.king.senate.gov/

Rep. Chellie Pingree – (D) 1st District
Maine Office: 2 Portland Fish Pier, Suite 304,
Portland, ME 04101
Maine Phone: (207) 774-5019
DC Office: 1318 Longworth HOB, Washington, D.C. 20515
DC Phone: (202) 225-6116
Email: link available at: http://pingree.house.gov/

Rep. Jared Golden – (R) 2nd District

Bangor Office: 6 State Street, Suite 101, Bangor, ME 04401
Bangor Phone: (207) 249-7400
DC Office: 1724 Longworth HOB,
Washington, DC 20515
DC Phone: (202) 225-6306
Email: link available at: https://golden.house.gov/