Proposed Rulemaking

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MaineCare Benefits Manual, Chapter II, Section 45, Hospital Services word  pdf 
Concise Summary: This proposed rulemaking seeks to permanently adopt changes already made on an emergency basis, implementation of a budget savings initiative of LD 250, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2013. This change reduces reimbursement for leave of absence days awaiting nursing facility placement from thirty-six days in the State’s fiscal year (July 1 through June 30) to one, and for the period March 1, 2013 through July 1, 2013. Hospitals will be reimbursed for only one day of leave of absence for days awaiting nursing facility placement. The Department is seeking approval from the federal Centers for Medicare and Medicaid Services for a state plan amendment for this change.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 14, 2013
 
Chapter 101, MaineCare Benefits Manual, Chapter III, Section 45, Hospital Services word  pdf 
Concise Summary: This proposed rulemaking seeks to permanently adopt changes already made on an emergency basis, implementation of a budget savings initiative of LD 250, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2013. This rule allows reimbursement for a distinct substance abuse unit discharge rate for acute care non-critical access hospitals who meet the standard. The rate is $4,898 per stay. The Department is seeking CMS approval of the state plan for this change.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 14, 2013
 
, MaineCare Benefits Manual, Chapter I, Section 1, General Administrative Policies and Procedures. word  pdf 
Concise Summary: This rule change is proposed to permanently adopt the provisions within an emergency rule which will expire on June 24, 2013. The federal Patient Protection and Affordable Care Act of 2010 (PPACA) requires the suspension of payments to providers who are the subject of a credible allegation of fraud. This proposed rule defines the term “credible allegations of fraud” and provides for exceptions and appeal procedures consistent with the requirements of the PPACA. As authorized by the State Legislature, this rule provides for a person to request expedited relief from a suspension of payments.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 14, 2013
 
MaineCare Benefits Manual, Section 19, Chapters II & III, Home and Community Benefits for the Elderly and for Adults with Disabilities word  pdf 
Concise Summary: The Department is proposing changes to this rule to provide services for members using Home and Community Benefits for the Elderly and for Adults with Disabilities (Section 19) concurrently with the operation of a 1915(b) Non-Emergency Transportation Waiver. These proposed changes to Section 19 will be effective only upon implementation of the 1915(b) Non-Emergency Transportation Waiver. Members who receive services under this policy will be provided Non-Emergency Transportation under Section 113 of the MaineCare Benefits Manual. The Department will contract with Broker(s) to establish, manage, authorize, coordinate and reimburse the provision of Non-Emergency Transportation services for eligible MaineCare members. The Broker(s) will be responsible for establishing a network of Non-Emergency Transportation drivers to deliver Non-Emergency Transportation services to eligible members who live in their assigned region. The proposed rule also makes technical changes to language and names when usage has changed or has been deemed inappropriate by the Maine Legislature. Specifically, the changes: a. Replace references to “mental retardation” with references to “intellectual disability”, as required by P.L. 2012, Ch. 542, §B(5), An Act To Implement the Recommendations of the Department of Health and Human Services and the Maine Developmental Disabilities Council Regarding Respectful Language; b. Replace references to “Office of Integrated Access and Support” with references to “Office of Family Independence,”; c. Replace references to “Office of Adults with Cognitive and Physical Disabilities Services” with references to “Office of Aging and Disability Services”; and, d. Remove “if CMS approves” language, as CMS approved the changes, effective 9/1/10.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 14, 2013
 
MaineCare Benefits Manual, Chapter 101, Chapter III, Section 32, Allowances for Waiver Services for Children with Intellectual Disabilities or Pervasive Developmental Disorders word  pdf 
Concise Summary: This rule is to permit MaineCare members to access transportation services along with their 1915(c) Home and Community Benefits. The Department is proposing changes to this rule to provide services for members with Intellectual Disabilities and Autistic Disorders concurrently with the operation of a 1915(b) Non-Emergency Transportation Waiver. These proposed changes to Section 32 will be effective only upon implementation of the 1915(b) Non-Emergency Transportation Waiver. Members who receive services under this policy will be provided Non-Emergency Transportation under Section 113 of the MaineCare Benefits Manual. The Department will contract with Broker(s) to establish, manage, authorize, coordinate and reimburse the provision of Non-Emergency Transportation services for eligible MaineCare members. The Broker(s) will be responsible for establishing a network of Non-Emergency Transportation drivers to deliver Non-Emergency Transportation services to eligible members who live in their assigned region.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 13, 2013
 
MaineCare Benefits Manual, Section 29, Chapter II, Support Services for Adults with Intellectual Disabilities or Autistic Disorder WORD  PDF 
Concise Summary: The Department is proposing a number of unrelated changes to this rule. The Department is proposing changes to the rule to comply with the concurrent operation of a 1915 (b) Non-Emergency Transportation Waiver. These proposed changes to Section 29 will be effective only upon implementation of the 1915(b) Non-Emergency Transportation Waiver. The proposed change to Section 29 includes referencing the regional, risk-based, pre-paid ambulatory health plan (PAHP) Brokerages operating under a 1915(b) waiver approved by the Centers for Medicare and Medicaid Services (CMS). Under risk-based contractual agreements, the Department will contract with Broker(s) to establish, manage, authorize, coordinate and reimburse the provision of Non-Emergency Transportation (NET) services for eligible MaineCare members. The Broker(s) will be responsible for establishing a network of NET drivers to deliver NET transportation services to eligible members who live in their assigned region. The Department is also proposing a number of other technical changes. 1. The Department is proposing to add language clarifying that, for purposes of initial and continuing eligibility, the annual cost of a member’s services under the Section 29 waiver may not exceed fifty percent (50%) of the statewide average annual cost of care for an individual in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), as determined by the Department. The rule will also clarify that reimbursement for Employment Specialist Services is limited to ten hours per month. Neither of these limits is new; each was included in the waiver application approved by CMS, but had not previously been identified in the Section 29 policy. 2. The website for The Maine College of Direct Support is being updated to a current link and can be accessed on the internet at: http://www.maine.gov/dhhs/oads/disability/ds/cds/index.shtml 3. The proposed rule makes technical changes to language and names when usage has changed or has been deemed inappropriate by the Maine Legislature. Specifically, the changes: a. Replace references to “mental retardation” with references to “intellectual disability” as required by P.L. 2012, ch. 542, § B(5), An Act To Implement the Recommendations of the Department of Health and Human Services and the Maine Developmental Disabilities Council Regarding Respectful Language; b. Replace references to “Office of Integrated Access and Support” with references to “Office of Family Independence”; c. Replace references to “Office of Adults with Cognitive and Physical Disabilities Services” with references to “Office of Aging and Disability Services”; d. Clarify the definitions of Correspondent, Case manager, Intellectual Disability and Autism. This change is to align this policy with services provided under Section 21 of the MaineCare Benefits Manual; and, e. Remove language making certain provisions contingent on approval by CMS, as CMS has now granted approval. 4. The Department is proposing to add language clarifying that the assessment referral form may be the BMS 99 form currently in use or some other form approved by the Department. This change is in anticipation of a move to a new functional assessment tool, the Supports Intensity Scale (SIS). 5. Requirements for Direct Support Professionals are being added, requiring DSPs to complete four specific modules prior to being left alone with a member. 6. The Department is proposing language requiring providers to put in place an informed consent policy and comply with the Department’s regulations governing reportable events. These are not new requirements, but had previously been included directly in the contracts between the Department and individual providers. 7. The Department is proposing various clarifications to the planning process. 8. The Department is proposing to delete Appendix III and replace it with a more simple statement of the combined limits on Work Support and Community Support in the main text of the rule.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 13, 2013
 
MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder WORD  PDF 
Concise Summary: This letter gives notice of a proposed rule: MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Adults with Intellectual Disabilities or Autistic Disorder. The Department of Health and Human Services (DHHS) is proposing two substantive changes to Chapter III, Section 21 of the MaineCare Benefits Manual. First, the Department is proposing to remove the procedure code for Transportation Services, in order to comply with the concurrent operation of a new 1915(b) Non-Emergency Transportation Waiver. These proposed changes to Section 21 will be effective only upon implementation of the 1915(b) Non-Emergency Transportation Waiver. Going forward, members who receive services under the Section 21 waiver will be provided non-emergency transportation through Section 113 of the MaineCare Benefits Manual. Under risk-based contractual agreements, the Department will contract with Broker(s) to establish, manage, authorize, coordinate and reimburse the provision of non-emergency transportation services for eligible MaineCare members. The Broker(s) will be responsible for establishing a network of non-emergency transportation drivers to deliver non-emergency transportation services to eligible members who live in their assigned region. Second, the Department is proposing to add a HCPCS procedure code for Behavioral Consultation, G9007 HI. The proposed reimbursement rate for Behavioral Consultation is $14.85 per fifteen minute unit. The Centers for Medicare and Medicaid Services have approved the addition of Board Certified Behavior Analyst to provide Behavioral Consultation. Lastly, the Department is also proposing to update several internet addresses that appear through Chapter III, Section 21. Rules and related rulemaking documents may be reviewed at, or printed from, the MaineCare Services website at http://www.maine.gov/dhhs/oms/rules/index.shtml or for a fee, interested parties may request a paper copy of rules by calling (207) 287-9368. For those who are deaf or hard of hearing and have a TTY machine, the TTY number is 711. A concise summary of the proposed rule is provided in the Notice of Agency Rule-making Proposal, which can be found at http://www.maine.gov/sos/cec/rules/notices.html. This notice also provides information regarding the rule-making process. Please address all comments to the agency contact person identified in the Notice of Agency Rule-making Proposal
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 13, 2013
 
MaineCare Benefits Manual, Section 21, Chapter II, Home and Community Benefits for Members with Intellectual Disabilities or Autistic Disorders word  pdf 
Concise Summary: The Department is proposing a number of unrelated changes to this rule. The Department is proposing changes to the rule to comply with the concurrent operation of a 1915 (b) Non-Emergency Transportation Waiver. These proposed changes to Section 21 will be effective only upon implementation of the 1915(b) Non-Emergency Transportation Waiver. The proposed change to Section 21 includes referencing the regional, risk-based, pre-paid ambulatory health plan (PAHP) Brokerages operating under a 1915(b) waiver approved by the Centers for Medicare and Medicaid Services (CMS). Under risk-based contractual agreements, the Department will contract with Broker(s) to establish, manage, authorize, coordinate and reimburse the provision of Non-Emergency Transportation (NET) services for eligible MaineCare members. The Broker(s) will be responsible for establishing a network of NET drivers to deliver NET transportation services to eligible members who live in their assigned region. The Department is also proposing other technical changes. 1. The website for The Maine College of Direct Support is being updated to a current link and can be accessed on the internet at: http://www.maine.gov/dhhs/oads/disability/ds/cds/index.shtml 2. The Department is proposing to add language clarifying that the assessment referral form may be the BMS 99 form currently in use or some other form approved by the Department. This change is in anticipation of a move to a new functional assessment tool, the Supports Intensity Scale (SIS). 3. Requirements for Direct Support Professionals are being added, requiring DSPs to complete four specific modules prior to being left alone with a member. 4. The Department is proposing to delete Appendix IV and replace it with a more simple statement of the combined limits on Work Support and Community Support in the main text of the rule.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 13, 2013
 
MaineCare Benefits Manual, Chapters II, Section 113, Non-emergency NET Transportation Services WORD  PDF 
Concise Summary: On June 6, 2012, the Centers for Medicare and Medicaid (CMS) approved a 1915(b) waiver to provide Medicaid non-emergency medical transportation using a regional risk-based prepaid ambulatory health plan (PAHPS). The waiver ends on June 30, 2013, and the Department is engaged in discussions with CMS to extend the transportation waiver. The CMS approval provided that two provisions of Title XIX of the Social Security Act are waived: (1) Section 1902(a)(4)(single source provider); and (2) Section 1902(a)(23)(Freedom of Choice). MaineCare members eligible to receive non-emergency transportation services under this waiver include members who receive home and community-based services (HCBS) waiver programs. In developing its waiver application, from late 2010 through 2012, the Department had conducted several meetings regarding MaineCare transportation with stakeholders in various forums. The Department met with the Maine Transportation Association multiple times, presented information to the MaineCare Advisory Committee at monthly meetings throughout the process, consulted with the Federally Recognized Tribes, as well as conducting multiple stakeholder meetings pertaining to the RFP. These meetings included meeting with advocacy groups such as Speak Up for Us, with the local transportation companies and also internal stakeholders in the Maine Department of Transportation. The Department issued an RFP for this transportation waiver services, and is concluding contracts with several entities, who are known as “Brokers”, and who will provide MaineCare transportation services regionally, throughout the state. The Department will reimburse the Brokers on a per member/per month fee. The Brokers will be responsible for establishing a network of Drivers to deliver the transportation services to MaineCare members who live in their assigned region. This rule proposes to repeal in its entirety the current Section 113 (Transportation Services), ch. II and III, and replaces it with the proposed rule.
Submit Comments (Opens in new window) - Comment Deadline: June 14, 2013 Posted: May 10, 2013
 
MaineCare Benefits Manual, Chapter II, Section 67, Nursing Facility Services    
Concise Summary: This rulemaking seeks to permanently implement changes made on an emergency basis, a budget savings initiative of LD 250, An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2013. If CMS approves, payment of bed holds for a semi-private room for a short-term hospitalization of the member shall be granted up to four (4) days’ (midnights) absence through June 30, 2013, as long as the member is expected to return to the nursing facility. Effective July 1, 2013, payment for these bed holds shall be granted up to four (4) days’ (midnights) absence during the twelve (12) month state fiscal year (July 1 through June 30) and every state fiscal year thereafter. The Department will also, if CMS approves, reduce reimbursement for a leave of absence from thirty-six days in a twelve-month period to no more than one (1) day in leave of absence from March 25, 2013 through June 30, 2013; and, effective July 1, 2013, one (1) day of leave of absence during the twelve (12) month state fiscal year (July 1 through June 30) and every state fiscal year thereafter. This proposed rule also incorporates additional changes to those made on an emergency basis by removing references to “transportation agency” and replacing it with a new Non-Emergency Transportation (NET) Broker, in order to comply with the new transportation broker program the Department is proposing in Section 113.
Submit Comments (Opens in new window) - Comment Deadline: June 13, 2013 Posted: May 7, 2013
 
MaineCare Benefits Manual, Chapter III, Section 65, Behavioral Health Services WORD  PDF 
Concise Summary: This proposed rule seeks to permanently adopt a 5% reduction to reimbursement rates for Licensed Clinical Professional Counselors (LCPC) and Licensed Marriage and Family Therapists (LMFT), as directed by the Maine State Legislature in P.L. 2013, Ch. 1, § A-23 (“An Act To Make Supplemental Appropriations and Allocations for the Expenditures of State Government and To Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Year Ending June 30, 2013”). This change in rates requires a State Plan Amendment to be approved by the Centers for Medicare and Medicaid Services (CMS); the Department will request approval of a State Plan Amendment retroactive to March 5, 2013
Submit Comments (Opens in new window) - Comment Deadline: May 9, 2013 Posted: April 5, 2013
 
MaineCare Benefits Manual, Chapters II & III, Section 20, Home and Community Based Services for Adults with Other Related Conditions WORD  PDF 
Concise Summary: The Department is creating a new Section of the MaineCare Benefits Manual outlining the covered services, program requirements, and reimbursement rates for a home- and community-based program for adults with “Related Conditions.” A “Related Condition” (defined in full at 42 C.F.R. § 435.1010) is a condition that causes impairment of general intellectual functioning or adaptive behavior similar to the impairment characteristic of an intellectual disability. This new MaineCare program, provided to eligible members through a Home and Community Based Waiver program approved by the Centers for Medicare and Medicaid Services, will provide supports necessary to assist individuals with a Related Condition to live in the community rather than in institutional settings. Chapter II of Section 20 (titled “Home and Community Based Services for Adults with Other Related Conditions Services”) will detail the program requirements and services offered under the waiver. Those services include Assistive Technology, Care Coordination, Communication Aids, Community Support, Consultation and Assessment, Employment Specialist Services, Home Accessibility Adaptations, Home Support, Non-Medical Transportation Services, Non-Traditional Communication Assessment, Non-Traditional Communication Consultation, Occupational Therapy (Maintenance) Service, Personal Care, Physical Therapy (Maintenance) Service, Specialized Medical Equipment, Speech Therapy (Maintenance) Service, and Work Support. Chapter III of Section 20 (titled “Allowances for Home and Community Based Services for Adults with Other Related Conditions“) establishes billing procedure codes (based on HIPAA compliant CPT coding) and reimbursement rates for the waiver services.
Submit Comments (Opens in new window) - Comment Deadline: May 11, 2013 Posted: April 4, 2013
 
MaineCare Benefits Manual, Chapter II, Section 65, Behavioral Health Services WORD  PDF 
Concise Summary: This proposed rule seeks to permanently adopt the emergency rule in accordance with P.L. 2011, ch. 657, (L.D. 1746), Part A, S, § S-1 (125th Legis.) effective January 1, 2013 that limits MaineCare reimbursement for methadone for the treatment of addiction to opioids to a maximum of twenty four (24) months per lifetime, except as permitted with prior authorization beyond twenty-four (24) months. Only treatment after January 1, 2013 will count toward the limit.
Submit Comments (Opens in new window) - Comment Deadline: April 26, 2013 Posted: March 27, 2013
 
MaineCare Benefits Manual, Chapter II, Section 85, Physical Therapy Services Word  PDF 
Concise Summary: This proposed rule will increase the limits for Physical Therapy Services to allow for up to five (5) treatment visits and one (1) evaluation within twelve (12) months, when provided pursuant to a pain management care plan.
Submit Comments (Opens in new window) - Comment Deadline: Midnight March 21, 2013 Posted: February 20, 2013
 
MaineCare Benefits Manual, Chapter II, Section 80, Pharmacy Services. Word  PDF 
Concise Summary: This proposed rule will impose limits on opioid medications used for the treatment of pain, pursuant to PL 2011, ch. 657, Part O, the Department of Health and Human Services 3rd Supplemental Budget. The rule includes definitions of acute and non-acute pain, establishes certain exclusions as described in the legislation, mandates the use of a pain management care plan when a member requires the use of opioid medications for the treatment of pain beyond the prescribed limits, and identifies therapeutic treatment options that must be utilized for members who are prescribed opioid medications to treat non-acute pain.
Submit Comments (Opens in new window) - Comment Deadline: Midnight March 21, 2013 Posted: February 20, 2013
 
MaineCare Benefits Manual, Chapters II & III, Section 91, Health Home Services Word  PDF 
Concise Summary: This proposed rulemaking seeks to permanently adopt Health Home Services which were put into place via emergency rule, effective January 1, 2013. This is a new MaineCare regulation which establishes “Health Homes” for MaineCare beneficiaries who suffer from certain chronic health conditions (including a mental health condition [excluding Serious and Persistent Mental Illness and Serious Emotional disturbance]; a substance use disorder; tobacco use; diabetes; heart disease; overweight or obese as evidenced by a Body Mass Index over 25; Chronic Obstructive Pulmonary Disease; hypertension; hyperlipidemia; developmental and intellectual disorders; circulatory congenital abnormalities; asthma; acquired brain injury; and seizure disorders). Congress enacted the Affordable Care Act which, in part, authorized States to offer Medicaid Health Home Services as a way to improve health care through coordinated care and at a reduced cost. For the first two years that a state offers Medicaid Health Home Services, the federal matching rate equals 90%. Under Maine’s Health Home program, members eligible for Health Home services will be assigned to a “Health Home Practice”(HHP, which is a primary care practice that has completed an application and been approved by MaineCare as an HHP). The HHP is responsible for providing acute and preventive care, managing chronic illnesses, coordinating specialty care and referrals to social, community, and long-term care supports, providing comprehensive care management, and providing access to 24/7 coverage. The HHP is required to work with a Community Care Team (CCT is a multi-disciplinary, community-based, practice-integrated care management team that has completed an application and been approved by MaineCare as a CCT) to identify members with the most intense health care needs and to provide more intense Health Home services for such members. The number of members receiving CCT services at any point in time is capped at 5% of each HHP’s members.
Submit Comments (Opens in new window) - Comment Deadline: Midnight, Thursday March 7, 2013 Posted: February 5, 2013
 
MaineCare Benefits Manual, Chapter VI, Section 1, Primary Care Case Management Word  PDF 
Concise Summary: The Patient Centered Medical Home (PCMH) program is being replaced by the Health Home Initiative described in the new/proposed MaineCare Benefits Manual, Chapters II & III, Section 91 (“Health Home Services”) that is concurrently going through the rulemaking process.
Submit Comments (Opens in new window) - Comment Deadline: Midnight, Thursday March 7, 2013 Posted: February 5, 2013
 
Credible Allegation of Fraud Word   
Concise Summary: This letter gives notice of an emergency rule which amends MaineCare Benefits Manual (MBM), Chapter 1, Section 1, § 1.18 (H), Program Integrity; § 1.19-6, Suspension or Withholding of Payments; § 1.20-3, Suspension of Payments Upon Credible Allegation of Fraud. The federal Patient Protection and Affordable Care Act of 2010 (PPACA) requires the suspension of payments to providers who are the subject of a credible allegation of fraud. The 125th Maine Legislature, Second Regular Session, enacted 22 MRSA § 1714-D to conform with PPACA requirements regarding the suspension of payments, in whole or in part, to providers who are subject to credible allegations of fraud. The rule defines the term “credible allegations of fraud” and provides for exceptions and expedited relief from suspension of payments. The effective date of the emergency rule is December 28, 2012. Before the emergency rule is adopted, the Department will give notice of the emergency rulemaking to interested parties and providers through a MaineCare provider listserv notification. Public comments regarding the emergency rule will be accepted from December 7, 2012 through December 12, 2012.
Submit Comments (Opens in new window) - Comment Deadline: December 12, 2012 Posted: December 6, 2012
 
MaineCare Redesign Task Force Word   
Concise Summary: The MaineCare Redesign Task Force will hold a public hearing on the draft of the “MaineCare Redesign Task Force, Recommendation Report” that was written pursuant to Public Law 2011, Chapter 657, Part T. The hearing will be held on December 11, 2012 from 1 – 3 pm in Statehouse, Room 228 (Appropriations Committee Room). Interested parties are encouraged to provide testimony on the draft report, which can be viewed at http://www.maine.gov/dhhs/mainecare-task-force/. To ensure all interested parties are able to provide input, oral testimony will be limited to 3 minutes per participant. For those who would like to submit written testimony it can be emailed to nick.adolphsen@maine.gov; mailed to Nick Adolphsen, Department of Health and Human Service, 11 State House Station, Augusta, ME 04333; or delivered to the Task Force at the hearing on 12/11.
Submit Comments (Opens in new window) - Comment Deadline: December 11, 2012 Posted: December 4, 2012
 
MaineCare Benefits Manual, Chapters II & III, Section 65, Behavioral Health Services WORD  PDF 
Concise Summary: This rule is being proposed, in part, to comply with Public Law 2011, Chapter 477, (the Maine State Supplemental Budget) passed by the 125th Maine State Legislature and signed into law by Governor Paul R. LePage on February 23, 2012, section M-1 of which required that MaineCare Services reduce reimbursement of Opioid Treatment (Methadone) from $72.00 per week to $60.00. This change is currently in effect through an emergency rule, effective June 29, 2012. PLEASE NOTE THAT DEADLINE FOR RECEIVING COMMENTS IS SEPTEMBER 14, 2012
Submit Comments (Opens in new window) - Comment Deadline: September 14, 2012 Posted: August 16, 2012
 
MaineCare Benefits Manual, Ch II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autistic Disorders WORD  PDF 
Concise Summary: The Department is proposing a number of unrelated changes to this rule. First, the Department proposes, as required by Resolves 2011, ch. 49, to remove language from § 21.02-7 (Employment Setting) stating that “Members with disabilities should constitute no more than 50% of the business’s workforce at any given worksite or location.” Second, the Department proposes to add language to clarify that a Licensed Clinical Social Worker (LCSW) or Licensed Clinical Professional Counselor (LCPC) can provide psychological or behavioral consultation. Additionally, if approved by CMS, the Department is proposing to expand the list of qualified providers who can provide psychological or behavioral consultation to include Board Certified Behavior Analysts (BCBAs). Third, the Department is proposing several limits on Section 21 services. Under the proposed rule, no one-member Agency Home Support placements will be approved after the rule has been adopted. Also, the Home Support ¼ hour- T2017 will be limited to three hundred and thirty six (336) quarter hour units or eighty four (84) hours a week. The proposed rule would also limit authorizations for services to be provided out-of-state to (60) days of service within a given fiscal year and sixty (60) days within any six (6) month period. Fourth and lastly, language that had previously been in provider contracts or riders is being proposed to be added to the policy, and various technical language changes are also being proposed. PLEASE NOTE THAT DEADLINE FOR RECEIVING COMMENTS IS AUGUST 26, 2012.
Submit Comments (Opens in new window) - Comment Deadline: August 26, 2012 Posted: July 19, 2012
 
MaineCare Benefits Manual, Chapter III, Section 2, Adult Family Care Services Word   PDF  
Concise Summary: This proposed rule seeks to reduce rates paid under this section by 10%. These changes would permanently adopt changes already made on an emergency basis that took effect April 1, 2012. The reduction in rates was directed in the supplemental budget, P.L. 2011, ch. 477, part M-1.
Submit Comments (Opens in new window) - Comment Deadline: June 1, 2012 Posted: May 1, 2012
 

 

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