MaineCare Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 18, Home and Community Based Services for Members with Brain Injury

Sep 12, 2024

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes.  The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. 

Below, please find a MaineCare Notice of Agency Waiver Amendment. You can access the complete details at http://www.maine.gov/dhhs/oms/rules/index.shtml.

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Notice of Agency Waiver Amendment

AGENCY:  Department of Health and Human Services, MaineCare Services

RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 18, Home and Community Based Services for Members with Brain Injury

WAIVER: ME.1082, Home and Community Based Services for Members with Brain Injury Waiver

CONCISE SUMMARY: The Department plans to submit an amendment to the Section 18, Home and Community Based Services (HCBS) for Members with Brain Injury HCBS 1915(c) waiver application.  This waiver amendment adjusts funding and rates to reflect the elimination of health care services from the Maine State Service Provider Tax in accordance with 36 M.R.S. § 2552, effective January 1, 2025.

Effective January 1, 2025, Section 18 services for which the Department has documentation that the cost of the current 6% Maine State Service Provider Tax (SPT) (36 M.R.S. § 2552) has been built into the rates will receive a corresponding 6% rate reduction to comply with PL 2023, ch 412, An Act Making Unified Appropriations and Allocations from the General Fund and Other Funds for the Expenditures of State Government and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2023, June 30, 2024 and June 30, 2025.

The impacted services and corresponding codes in Section 18 are:

Procedure Code	Modifier	Description
T2015	U9	Career Planning, per Hour
T2019	U9	Employment Specialist, 15 Min
T2016	U9	Home Support Level II, 2-4 Beds, per Diem
T2016	U9, TT	Home Support Level II, 5-8 Beds per Diem
T2017	U9	Home Support, 15 Min
T2017	U9, U6	Home Support, Self-directed, 15 Min
T2017	U9, QC	Remote Monitor Only Home Support, 15 Min
T2017	U9, GT	Remote Interactive Home Support, 15 Min
S5102	U9	Clubhouse, per Diem
H2023	U9	Work Support, 15 Min

 

Please see the accompanying draft application for a complete list of all proposed changes included in the waiver amendment. 

DHHS is accepting comments through 11:59 pm, October 11, 2024. Any interested party may obtain a copy of the waiver amendment by going to the website noted below or at any regional Office for Family Independence (a list of the offices and locations can be found at this link http://www.maine.gov/dhhs/ofi/offices/index.html).

A printed copy may be obtained by calling Lisa Weaver at (207) 624-4050 or emailing:lisa.weaver@maine.gov.

See http://www.maine.gov/dhhs/oms/rules/index.shtml for waiver amendment and to submit comments.

STATUTORY AUTHORITY:             42 CFR §441.304

DEADLINE FOR COMMENTS:       Comments must be received by 11:59 pm, October 11, 2024.

AGENCY CONTACT PERSON:        Heather Bingelis, Comprehensive Health Planner II

AGENCY NAME:                               MaineCare Services

ADDRESS:                                          109 Capitol Street, 11 State House Station

                                                             Augusta, Maine 04333-0011

                                                              Heather.bingelis@maine.gov

TELEPHONE:    207-624-4951 FAX: (207) 287-1864 TTY: 711