Date posted:
Attachment(s):
Notice of MaineCare Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of MaineCare Services
SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Family Planning Services
NATURE OF PROPOSED CHANGES: The Department plans to amend reimbursement of certain family planning services, effective July 1, 2024. These changes are as follows:
- Increase reimbursement for certain Medicaid-covered family planning and family planning related services to 100% of the current Medicare reimbursement amount.
- Amend the reimbursement methodology for MaineCare-covered Long-Acting Reversible Contraception (LARCs) to equal the average wholesale acquisition cost (WAC).
REASON FOR PROPOSED CHANGES: All changes are pursuant to Maine P.L. 2023 ch. 643, An Act to Make Supplemental Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and to Change Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2024 and June 30, 2025.
ESTIMATE OF ANY EXPECTED INCREASE OR DECREASE IN ANNUAL AGGREGATE EXPENDITURES: The Department anticipates that this change will cost $196,775 in federal fiscal year 2024 which includes $177,098 in federal funds and $19,677 in state funds, and will cost $787,098 in federal fiscal year 2025 which includes $708,388 in federal funds and $78,710 in state funds.
ACCESS TO PROPOSED CHANGES AND COMMENTS TO PROPOSED CHANGES: The public may review the proposed methodology changes and written comments at any Maine DHHS office in every Maine county. To find out where the Maine DHHS offices are located, call 1-800-452-1926. The Department will hold a hearing for the proposed rulemaking and will be publishing a notice which includes information on the hearing date and location.
CONTACT INFORMATION FOR RECEIPT OF COMMENTS: Kristin Merrill
AGENCY NAME: Office of MaineCare Services
ADDRESS: 109 Capitol Street, 11 State House Station
Augusta, Maine 04333-0011
TELEPHONE:(207) 624-4006 FAX: (207) 287-6106
TTY: 711 Maine Relay (Deaf or Hard of Hearing)
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
State Plan Amendment
Office: MaineCare Services
Email: Kristin.Merrill@maine.gov
Comment deadline:
On