Maine Code § 22-1714-A

Debts owed the department by providers
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1. Definitions. As used in this section, unless the context otherwise indicates, the following terms
have the following meanings.
A. "Boarding home" means any facility that meets the definition of former section 7901-A,
subsection 4 or the definition of residential care facility in section 7852, subsection 14. [PL 2001,
c. 596, Pt. B, §3 (AMD); PL 2001, c. 596, Pt. B, §25 (AFF).]
B. "Debt" means any amount of money that is owed to the department as a result of:
(1) Overpayments that have been determined by a department audit pursuant to the applicable
principles of reimbursement, overpayments as reported by a provider in an unaudited cost
report or overpayments that have been discovered in any other manner;
(2) The department's authority to recapture depreciation;
(3) The assessment of fines and sanctions;
(4) Projected overpayments reported in an interim cost report. If an interim report is not filed
at least 30 days prior to the transfer, "debt" also includes 5% of Medicaid reimbursement or
cost reimbursement for the last fiscal year or $50,000, whichever is less; or
(5) A final reconciliation decision and order by the former Maine Health Care Finance
Commission. [PL 2007, c. 466, Pt. A, §42 (AMD).]
C. "Former provider" means the person reimbursed by the department for the provision of health
care services at a nursing home, boarding home, hospital or other provider of health care services
prior to its transfer. [PL 2011, c. 687, §5 (AMD).]
D. "Hospital" means any facility licensed pursuant to sections 1811 and 1817. [PL 1991, c. 9,
Pt. G, §4 (NEW).]
E. "Interim cost report" means a cost report that covers the current fiscal year and any prior periods
not covered by a previously filed cost report. Cost incurred in the 90 days prior to the transfer need
not be covered in the interim cost report. [PL 1991, c. 9, Pt. G, §4 (NEW).]
F. "Nursing home" means any facility that meets the definition of section 1812-A, including an
intermediate care facility for persons with intellectual disabilities. [PL 2011, c. 542, Pt. A, §27
(AMD).]
G. "Person" means any natural person, partnership, association, corporation or other entity
including any county, local or other governmental unit. [PL 1991, c. 9, Pt. G, §4 (NEW).]
H. "Provider" means a person reimbursed by the department for the provision of health care
services. [PL 1991, c. 9, Pt. G, §4 (NEW).]

I. "Transfer" means any change in the ownership or control of a nursing home, boarding home,
hospital or other provider of health care services, including, but not limited to, a sale, lease or gift
of the land, building or operating entity, that results in:
(1) The department reimbursing a person other than the former provider for the provision of
care or services; or
(2) The discontinuation of the provision of care or services. [PL 2011, c. 687, §6 (AMD).]
J. "Transferee" means any person to whom a nursing home, boarding home, hospital or other
provider of health care services is transferred. [PL 2011, c. 687, §6 (AMD).]
[PL 2011, c. 542, Pt. A, §27 (AMD); PL 2011, c. 687, §§5, 6 (AMD).]
2. Establishment of debt. A debt is established by the department when it notifies a provider of
debt that the provider owes the department pursuant to a decision and order that constitutes final agency
action. A debt is collectible by the department 31 days after exhaustion of all administrative appeals
and any judicial review available under Title 5, chapter 375.
[PL 2003, c. 419, §4 (AMD).]
3. Notice of debt. Any notice of debt issued to a provider by the department must include the
following:
A. A statement of the debt accrued; [PL 1991, c. 9, Pt. G, §4 (NEW).]
B. A statement of the time period during which the debt accrued; [PL 1991, c. 9, Pt. G, §4
(NEW).]
C. The basis for the debt; [PL 1991, c. 9, Pt. G, §4 (NEW).]
D. The debtor's right to request a fair hearing within 30 days of receipt of the notice; and [PL
1991, c. 9, Pt. G, §4 (NEW).]
E. A statement that after a debt is established, the department may proceed to collect that debt
through administrative offset, lien and foreclosure, or other collection action. [PL 1991, c. 9, Pt.
G, §4 (NEW).]
[PL 1991, c. 568, §1 (AMD).]
4. Successor liability. Liability of transferees is governed by this subsection.
A. When a nursing home, boarding home, hospital or other provider of health care services is
transferred, the transferee is liable for debts owed to the department by the former provider unless
by the time of sale:
(1) All debts owed by the former provider to the department have been paid, except as stated
in subparagraph (2);
(2) If the indebtedness is the subject of an administrative appeal, an escrow account has been
created and funded in an amount sufficient to cover the debt as claimed by the department; or
(3) An interim cost report has:
(a) Been filed and an escrow account has been created and funded in an amount sufficient
to cover any overpayment identified in the report; or
(b) Not been filed and an escrow account has been created and funded in an amount
sufficient to cover 5% of Medicaid reimbursement or cost reimbursement for the last fiscal
year or $50,000, whichever is less. [PL 2011, c. 687, §7 (AMD).]
B. Any person affected by this subsection may request that the department identify the amount of
any debt owed by a nursing home, boarding home, hospital or other provider of health care services.
When the department receives such a request, it shall identify the debt within 30 days. Failure to
identify the amount of a debt when a request is made in writing at least 30 days prior to the transfer

precludes the department from recovering that debt from the transferee. [PL 2011, c. 687, §7
(AMD).]
C. The department shall provide written notice of the requirements of this section to the transferee
in a letter acknowledging receipt of a request for a certificate of need or waiver of the certificate of
need for a nursing home or hospital transfer or in response to a request for an application for a
license to operate a boarding home or to provide other health care services. [PL 2011, c. 687, §8
(AMD).]
D. If a transferee becomes liable for a debt pursuant to this subsection, the transferee shall succeed
to any defenses to the debt that could have been exercised by the former provider. [PL 1991, c.
9, Pt. G, §4 (NEW).]
E. Nothing in this subsection may limit the liability of the former provider to the department for
any debts whether or not they are identified at the time of sale. In addition, a transferee has a cause
of action against a former provider to the extent that debts of the former provider are paid by the
transferee, unless the transferee has waived the right to sue the former provider for those debts.
[PL 1991, c. 568, §2 (AMD).]
F. The commissioner may waive all or part of a transferee's liability under this subsection if the
commissioner finds that a waiver of liability is in the public interest. [PL 1991, c. 568, §3
(NEW).]
[PL 2011, c. 687, §§7, 8 (AMD).]
5. Department may offset. The department may offset against current reimbursement owed to a
provider or any entity related by ownership or control to that provider any debt it is owed by that
provider after the debt becomes collectible. The department shall adopt rules that implement this
subsection and define the ownership or control relationships that are subject to an offset under this
subsection, except that the department may not define any ownership or control relationship as subject
to an offset unless the relationship allows the person whose relationship is the subject of the offset to
control at least the number of votes of the provider's governing body or management that is needed to
govern the operations of the provider. Rules adopted pursuant to this subsection are routine technical
rules as defined in Title 5, chapter 375, subchapter 2-A.
[PL 2017, c. 442, §1 (AMD).]
6. Liens. Collection by lien is as follows.
A. After a debt is collectible, the amount stated in the notice of debt or overpayment is a lien in
favor of the department against all real or personal property of the provider or any entity related by
ownership or control to the provider. [PL 1991, c. 568, §4 (NEW).]
B. The lien attaches to all real and personal property of the responsible party when the department
files in the registry of deeds of any county, or with any office appropriate for a notice with respect
to personal property, a certificate that states the name of the responsible party, that party's address,
the amount of debt accrued, the date of the underlying audit or decision and the name and address
of the authorized agent of the department who issues the lien. [PL 1991, c. 568, §4 (NEW).]
C. When a lien has been filed and the person having notice of the lien possesses any property that
may be subject to the lien, that property may not be paid over, released, sold, transferred,
encumbered or conveyed unless:
(1) A release or waiver signed by the commissioner has been delivered to the person in
possession of the property; or
(2) A court has ordered the release of the lien. A court may order a release only when
alternative security has been provided for the debt owed the department. [PL 1991, c. 568,
§4 (NEW).]

D. The commissioner may hold title to real or personal property for the purpose of foreclosure on
filed liens. Foreclosure must proceed as follows.
(1) Actions to foreclose liens on real property filed under this subsection may be brought in
the county where the lien is filed pursuant to the procedures of Title 14, chapter 713, subchapter
VI. For purposes of foreclosure by civil action as described in Title 14, chapter 713, subchapter
VI, a lien filed in accordance with this subsection constitutes a mortgage claim of the
department on any real property owned by the debtor. Failure to pay the debt owed the
department constitutes a breach of condition in the mortgage.
(2) Actions to foreclose liens on personal property filed under this subsection may be brought,
pursuant to Title 14, chapter 509, subchapter III, in the county where the lien is filed. [PL
1991, c. 568, §4 (NEW).]
[PL 1991, c. 568, §4 (NEW).]
7. Other collection actions. In addition to the other remedies provided in this section, the
department may seek collection of any debt established under subsection 2 pursuant to Title 14, chapter
502, Title 36, chapter 7 and Title 36, section 185-A.
A business entity, including a sole proprietorship, is considered out of business for the purposes of the
department's recovering indebtedness if, after reasonable investigation, the department or its legal
counsel has certified in writing that the business entity is no longer conducting operations and that there
is no realistic expectation of collecting any significant money from the entity based upon one or more
of the following conditions:
A. The business entity has ceased offering retail or wholesale goods and services to the public;
[PL 2003, c. 673, Pt. YYY, §1 (NEW).]
B. Upon reasonable investigation, nonexempt assets of the business entity of substantial value can
not be identified or are otherwise unavailable for attachment and recovery; [PL 2003, c. 673, Pt.
YYY, §1 (NEW).]
C. The business entity's physical location or locations of business are closed to the public; [PL
2003, c. 673, Pt. YYY, §1 (NEW).]
D. The business entity's corporate status is no longer in good standing; [PL 2003, c. 673, Pt.
YYY, §1 (NEW).]
E. The business entity has admitted that it has insufficient assets to satisfy the debt; [RR 2007, c.
2, §8 (COR).]
F. After reasonable investigation, the department or its counsel can not locate the business entity
or identify the debtor's nonexempt assets; and [PL 2003, c. 673, Pt. YYY, §1 (NEW).]
G. The business entity has transferred substantially all of its business assets to a 3rd party and there
are no recoverable assets as a result of the transfer. [PL 2003, c. 673, Pt. YYY, §1 (NEW).]
Certification by the department that a business entity is out of business under this subsection does not
preclude further collection and recovery procedures by the department, whether to formally adjudicate
the indebtedness or to proceed with collection and recovery if the department becomes aware of facts
that merit further recovery efforts.
[PL 2019, c. 659, Pt. D, §5 (AMD).]
8. Rulemaking. The department may adopt or amend any rule as necessary to implement this
section.
[PL 1991, c. 568, §4 (NEW).]
9. Cost-of-care overpayments. On or before June 30, 2015, the department shall collect the total
amount of debt arising from cost-of-care overpayments that exceeds by $4,000,000 the amount of that

debt that had been budgeted for fiscal year 2014-15 as of April 15, 2014. To the extent necessary to
meet this requirement, the department may establish payment terms, modify as otherwise permitted by
law existing payment agreements to accelerate payment terms and offset current payments in
accordance with subsection 5. If 7 days' notice and opportunity to comment are provided, the
department may adopt rules on an emergency basis to modify its implementation of subsection 5 on an
emergency basis for purposes of collecting cost-of-care overpayments without making the emergency
findings otherwise required by Title 5, section 8054, subsection 2.
[PL 2013, c. 594, §2 (NEW).]
10. No imposition of liability on other persons. The department may not by any means, including
without limitation any rule or any contract or agreement with a provider, impose liability for a debt
under this section on any person other than the provider notified of the debt pursuant to subsection 2 or
a person subject to collection by offset pursuant to rules adopted under subsection 5. This subsection
does not prohibit the department from seeking recovery of civil penalties from any person as provided
in section 15.
[PL 2017, c. 442, §2 (NEW).]

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