MaineCare Requirements

See our list of commonly used acronyms

Clarify ISP or IFSP for Maine Care students - speech, Occupational Therapy (OT), etc., objectives.

The IFSP or IEP is an ITP for students in the MaineCare system.
(Revised September 2010)

If a SAU has held a meeting to develop a MaineCare plan of care for a child identified as a child with a disability under MUSER, must the SAU send out a Written Notice (WN) after the meeting?

No, the only reason a SAU would send out a WN about such a meeting is if the meeting was also an IEP Team meeting. The determinations about a MaineCare plan of care would not be included in the WN.
(Added September 2010)

If a SAU is going to hold a meeting to develop a MaineCare plan of care for a child identified as a child with a disability under MUSER, must the SAU send out Advance Written Notice (AWN) about the meeting?

No, the only reason a SAU would send out AWN about such a meeting is if the meeting is also an IEP meeting.
(Added September 2010)

Is the MaineCare Documentation Form a part of the IEP?

No, it is a separate MaineCare-required document that, for children who are identified as children with disabilities under MUSER and who are also covered by MaineCare, will be appended to the IEP. It is strongly advised that, for children who are eligible, the SAU keep two separate files: the special education file; and the MaineCare billing file, that would include the documentation requirements for each MaineCare section being billed.
(Added September 2010)

MaineCare requires that parents sign all plans & amendments yet IDEA does not require parent's signature.

IDEA requires consent for initial evaluation and initial provision of special education and related services and also for reevaluations (please see MUSER V.1. B.) Under the use of public insurance within the federal IDEA regulations, parents need to provide consent to access the public insurance, which is separate from the consent for initial evaluation. The USDOE has issued guidance that states that parents may be asked once to consent to use public insurance for the duration of the services in the IEP.
(Revised September 2010)

What will serve as the individual service plan for MaineCare purposes?
Please see the Administrative Letter from the Department of Education.

MaineCare Documentation Form
ADMINISTRATIVE LETTER: 4
POLICY CODE: DIC
TO: Superintendents of Schools, Special Education Directors, CDS Regional Boards of
Directors, CDS Regional Site Directors
FROM: Angela Faherty, Ph.D., Acting Commissioner
DATE: July 16, 2010
RE: Mainecare Documentation Form

The Departments of Education and Health and Human Services have been working collaboratively to develop refinements to Mainecare policies that will facilitate billing by school administrative units for medically necessary services. In addition, the Departments have reviewed the documentation requirements required by MaineCare in addition to the components of the Individualized Educational Program (IEP).

The Department of Health and Human Services has determined that a child’s
individualized educational program (IEP) contains all but three pieces of documentation that are necessary for MaineCare billing. The three pieces of additional documentation that are needed are the signatures and the date of the plan, the plan of care, and a Crisis/Safety Plan. A MaineCare Documentation form that covers these three requirements can be found at http://www.maine.gov/education/medicaid/index.html
For each MaineCare eligible child for whom the school administrative unit will seek reimbursement for MaineCare services provided to that child, the MaineCare Documentation form must be completed before September 1, 2010 when the new MaineCare data system goes into effect. The MaineCare Documentation form should be filed with the child’s IEP. If you have questions about this documentation process, please contact Jaci Holmes, Federal State Legislative Liaison, by phone at 624-6669 or by email at jaci.holmes@maine.gov.

In addition, short term objectives required by MaineCare are to be included in the MaineCare documentation as part of the plan of care.
(Added September 2010)

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