10-144 C.M.R. Chapter 332; MaineCare Eligibility Manual – Part 9: LIMITED BENEFIT GROUPS and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS] MaineCare Rule #312P – Part 9

Date posted:

Attachment(s):

10-144 C.M.R. Chapter 332; MaineCare Eligibility Manual – Part 9: LIMITED BENEFIT GROUPS and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS]

MaineCare Rule #312P – Part 9 and Chart 3.8 Premium Updates

PRINCIPAL REASON(S) OR PURPOSE FOR PROPOSING THIS RULE:  The Department proposes to update Part 9: LIMITED BENEFITS GROUPS and Chart 3.8: Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS]. The proposed rule changes are intended to provide clarity and increase accessibility for readers.

The proposed rule changes to Part 9, Section 1(2) Premiums include:

  • “Premiums are set by the Office of MaineCare Services and increase 5% annually on January 1st.
  • “Starting January 1, 2025, premium amounts due are posted online at https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance.” would replace “See Chart 3.8 for premium amounts due.”
  •   2(A) “$37.73” would replace “$35.93” and “$415.03” would replace “$395.23.”

For consistency and clarification, the Department proposes additional changes to Part 9 to include:

  • “250%” would replace “250 percent”
  • “Medicare” would replace “other benefits”
  •     “1st” would replace “first” for the first day of a calendar month.

The Department proposes to remove Chart 3.8 - Premiums for Special Benefits Waiver [Maine Section 1115 Health Care Reform Demonstration for Individuals with HIV/AIDS] from the charts and appendices. In addition, the proposed rule changes would add “Effective January 1, 2025, amounts due are posted online at https://www.maine.gov/dhhs/ofi/programs-services/health-care-assistance.” Further, “For additional information, see 10-144 Chapter 332; Part 9, Limited Benefit Group, Section 1(2) Premiums for Special Benefit Waiver” would be added.

Retroactive rulemaking is permissible under 22 M.R.S. § 42(8) as the proposed update does not negatively affect reimbursement or other payments, benefits or services for Special Benefits Waiver recipients under the rules previously in effect.

PUBLIC HEARING: No public hearing is scheduled.

COMMENT DEADLINE: Monday, April 14, 2025, at 5:00 p.m. Eastern Time.

Written public comments may be submitted via the link at https://www.maine.gov/dhhs/about/rulemaking.

AGENCY CONTACT PERSON:

Adam Hooper, MaineCare Program Manager

Department of Health and Human Services

Office for Family Independence

109 Capitol Street

Augusta, ME 04330-6841

Phone: (207) 441-4916/Fax: (207) 287-3455

TT Users Call Maine Relay – 711

Adam.Hooper@Maine.gov

 

Office: Office for Family Independence

Comment deadline:

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