Last updated: November 26, 2023. Jan 5, 2023 · This process is further outlined in the MaineCare Benefits Manual, Chapter II, Section 18. Mar 16, 2022 · CONCISE SUMMARY: The Department of Health and Human Services (the “Department”) proposes this rule change in 10-144 C. gov. 11 The CARF requirement has been deleted in Provider Specifications (C-1/C-3) for all services except Home Support-Per Diem Level II, Home Support-Per Diem Level III, and Work-Ordered Day Club House. Notice of Agency Rule-making Proposal. Requirements for financial record keeping are detailed in MaineCare Benefits Manual (MBM), Chapter I, Section 1. Phone: (207) 287-3707 FAX: (207) 287-3005 TTY: Maine relay 711 Jan 5, 2023 · Concise Summary: Notice of Agency Rule-making Adoption. maine. 48, § 3271(2)) to enroll and receive reimbursement through MaineCare; Removal of mileage reimbursement language to create consistency across the MaineCare Benefits Manual and minimize abuse of mileage reimbursement. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder. ADOPTED RULE NUMBER: Nov 18, 2021 · Nov 18, 2021. You can also email. . Chapter 101, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder May 12, 2022 · May 12, 2022. Coverage If one of these coverage groups describes your situation and you meet eligibility requirements other devices necessary for life support, ancillary supplies and equipment necessary for the proper functioning of such items, and durable and non-durable medical equipment that are not otherwise covered for reimbursement in the MaineCare Benefits Manual. chapter iii. CHAPTER II. , Chapter 101, MaineCare Benefits Manual, Chapter II, Section 94, Early and Periodic Screening, Diagnosis and Treatment Services (EPSDT). No asset test. 90. Department of Health and Human Services. You may also call the Covering Kids and Teens Help Line toll-free and TDD/TTY at: 1-800-965-7476. Pregnant Individuals Full MaineCare Benefit Apr 19, 2022 · MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility (CRCF) Services: Changes to Kepro Referrals and Prior Authorizations (PA) Apr 19, 2022 The PA will be valid for six months. 4% of the most recent 2024 Medicare rates. LAST UPDATED: 11/1/21. docx) format. Oct 28, 2019 · AGENCY: Department of Health and Human Services, Office of MaineCare Services. Prior Authorization Manual (PDF) 6. See full list on www1. To enable the OMS Program Integrity Unit to implement appropriate sanctions, the final rule allows the Department, in its discretion, to consider a request from a May 20, 2022 · The Department is adopting comprehensive amendments of 10-144 C. Chapter 101, MaineCare Benefits Manual, Chapter VI, Section 3, Primary Care Plus and 10-144 C. Oct 27, 2023 · SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual NATURE OF PROPOSED CHANGES: The Department plans to submit a Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA), effective January 1, 2024, to establish a health services initiative that will extend coverage of the CHIP Unborn Child Option (UCO) population to twelve The MaineCare Benefits Manual is Chapter 101 of 10-144, which outlines Rule Chapters for the Department of Health and Human Services. Oct 27, 2023 · SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual NATURE OF PROPOSED CHANGES: The Department plans to submit a Children’s Health Insurance Program (CHIP) State Plan Amendment (SPA), effective January 1, 2024, to establish a health services initiative that will extend coverage of the CHIP Unborn Child Option (UCO) population to twelve June 16, 2006. May 27, 2022 · The final rule also adds that providers must follow the provisions of their provider agreements and the MaineCare Benefits Manual to continue to receive reimbursement for services. Burns and Associates, a Division of Health Management Associates, conducted these rate studies. Sep 28, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. As previously announced, on November 8, 2023, the Office of MaineCare Services (OMS) formally adopted MBM, Chapter II, Section 71: NDPP Services. • Chapter I of the MBM covers general administrative policies and procedures that MaineCare-enrolled providers must follow. PROPOSED RULE NUMBER: 2023-P171 Apr 22, 2024 · The Department of Health and Human Services (Department) finally adopts the rule changes in 10-144 C. CHAPTER II MAINECARE BENEFITS MANUAL. (90. PROPOSED RULE NUMBER: 2023-P173. The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. May 16, 2022 · It is the provider’s responsibility to verify a member’s eligibility for MaineCare prior to providing services, as described in Chapter I, Section 1 of the MaineCare Benefits Manual. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. State of Maine Department of Health and Human Services. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder. Prior Authorization Manual. Providers submitted cost surveys in April and May of 2022. Option 4: Fax an application to (207) 778-8429. This is the overarching set of requirements for all MaineCare providers and will contain the responsibilities held by the MaineCare Provider Agreement. The MaineCare Member Handbook (PDF) includes information about the MaineCare program, benefits and services that MaineCare may cover, and community resources available. Benefit : 105% $1,276 $1,726 $2,176 $2,625 $450 Parents or caretakers must have children under age 18 living in the home and have primary responsibility for their day-to-day care. 76 Nov 2, 2023 · Listed below are the Sections 18, 21, and 29 Appendix K flexibilities that MaineCare intends to continue as permanent provisions and those that are expected to expire following CMS approval of the waiver amendments. MaineCare Application. Member Handbook. PROPOSED RULE NUMBER: 2023-P171 Jan 24, 2024 · AGENCY: Department of Health and Human Services, MaineCare Services. Archive. Modified. Jan 24, 2023 · MaineCare provides health insurance coverage for Maine children and adults who are older, disabled, and/or with low income (138% of the Federal Poverty Level (FPL) for all adults, and, starting in October 2023, 300% FPL for children through age 20). The MaineCare Benefits Manual. • Chapter II outlines covered services and the criteria associated with each covered AGENCY: Department of Health and Human Services, MaineCare Services. Updated PA criteria includes: May 22, 2023 · In the Spring of 2022, the Office of MaineCare Services (OMS) initiated rate determinations for MaineCare Benefits Manual (MBM) Sections 13, 17, 28, 65, and 92. AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy CHAPTER NUMBERS AND TITLES: 10-144 C. Section 25DENTAL SERVICES AND REIMBURSEMENT METHODOLOGYEstablished: 9/1/86. Comment Submission for Proposed Rules. Example: A family of four would need to earn $41,400 or less annually for the parents and Browse Maine Administrative Code | Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) for free on Casetext Aug 11, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. AGENCY: Department of Health and Human Services, MaineCare Services. 0995 (MBM Section 20), ME. By Muzaffar Chishti, Doris Meissner, Stephen Yale-Loehr, Kathleen Bush-Joseph and Christopher Levesque May 11, 2022 · CHAPTER NUMBER AND TITLE: 10-144 C. R. May 25, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. 2/16/2022. We would like to show you a description here but the site won’t allow us. Section 97PRIVATE NON-MEDICAL INSTITUTION SERVICES ESTABLISHED: 1/1/85. 08-8(C) is updated, the Prior Authorization (PA) department will review PA requests consistent with the updated requirements that will also be included in the PA criteria sheet located on the Health PAS online portal. Mar 22, 2024 · Where applicable, revised language to align and create consistency with ME. Jul 5, 2023 · The proposed rulemaking establishes 10-144 CMR Ch. Age 1 – 18 Full MaineCare Benefit 162% $1,835 $2,472 $3,110 $3,747 $638 Age 19 & 20 Full MaineCare Benefit You can also visit the Information for MaineCare Members section of our COVID-19 and the End of Public Health Information webpage. L. ADOPTED RULE NUMBER: CONCISE SUMMARY: These rules are adopted to comply with P. ADOPTED RULE NUMBER: Jan 11, 2022 · MAINECARE BENEFITS MANUAL CHAPTER II SECTION 65 BEHAVIORAL HEALTH SERVICES ESTABLISHED 8/1/08 EMERGENCY RULE LAST UPDATED 5/21/20 1 65. III, Section 67, Principles of Reimbursement for Nursing Facilities | Department of Health and Human Services Jun 15, 2022 · AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy. 101, MaineCare Benefits Manual, Chapter III, Section 21, Allowances for Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. Mainecare Benefits Manual, 10-144 C. The Department proposes this rule to align requirements with the Family First Prevention Services Act (FFPSA), which establishes MaineCare . Chapter 1 – Section 1: General Administrative Policies and Procedures. Jan 5, 2023 · We provide proposed and recently adopted rules until they are available in the MaineCare Benefits Manual, on the Secretary of the State’s webpage. If you are unable to submit a comment, please contact the policy writer identified in the rule. Please reference the MaineCare Benefits Manual (MBM) for complete descriptions of MaineCare service policies. 101, MaineCare Benefits Manual, Chapters II & III, Section 93, Opioid Health Home Services, to improve access to treatment, reduce administrative barriers to providing Medication Assisted Treatment (MAT), promote The MaineCare Benefits Manual Section 20 Waiver Program -- Home and Community Based Services for Adults with Other Related Conditions -- offers home and community-based services to individuals with Cerebral Palsy, Epilepsy, and Other Related Conditions. 0. Notice of Agency Rule-making Adoption. M. II, 21. Concise Summary: AGENCY: Department of Health and Human Services, Office of MaineCare Services SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 97, Private Non-Medical Institution Services NATURE OF PROPOSED CHANGES: The Department plans to submit a State Plan Amendment (SPA) for To see if a service you need is covered, call MaineCare Member Services at 1-800-977-6740. The Department proposes this rule in order to create a new section of policy describing MaineMOM Services. 10-144 Chapter 101. 101, MaineCare Benefits Manual, Chapter II, Section 97, Private Non-Medical Institution Services. iv. Talk with your health care provider or call MaineCare Member Services at 1-800-977-6740. 6. I, Section 5, COVID-19 Public Health Emergency Services, which allowed members to receive a second well-child visit when an initial visit was completed via telehealth. To see if you are eligible, to apply, or to report changes, call 1-855-797-4357. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder PROPOSED RULE NUMBER: Nov 21, 2023 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. TTY users, dial 711. SECTION 67. 0467 (MBM Section 29), and ME. MaineCare Benefits. May 29, 2024 · Notice of Agency Rule-making Proposal AGENCY: Department of Health and Human Services (DHHS), MaineCare Services, Division of Policy CHAPTER NUMBER AND TITLE: 10-144 C. The Department shall submit to CMS and anticipates approval for a State Plan Amendment related to these provisions. Jul 20, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. The Maine MaineCare (Medicaid) Program provides free or low-cost health coverage to eligible needy persons. CONCISE SUMMARY: Jan 22, 2024 · AGENCY: Department of Health and Human Services, MaineCare Services. Chapter 101 of the Department of Health and Human Services (Maine) Chapter 101:MaineCare Benefits Manual(formerly Maine Medical Assistance Manual)APA Office Department of the Secretary of State (Maine) This massive document, in Microsoft Word format, is divided into Chapters and Sections. 10-144 chapter 101. 05-21: PK !? x Å º [Content_Types]. gov We would like to show you a description here but the site won’t allow us. Jan 16, 2024 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. Please direction questions about the provision of School Health-Related Services to the MaineCare In Education email box. AGENCY: Department of Health and Human Services, Office of MaineCare Services CHAPTER NUMBER AND TITLE: 10-144 C. Chapter 1 – Section 6: Global HCBS Waiver Person-Centered Planning and Settings Rule the total acquisition costs. Ch. TTY users, dial 711 (Maine Relay). The Department added the requirement that residents must have a medical license for best practices (per Title 32, ch. May 12, 2022 · Notice of Agency Rule-making Adoption AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy CHAPTER NUMBER AND TITLE: 10-144 C. MANUAL. • MaineCare Non-Emergency Transportation (NET) brokers will not provide reimbursement for interpreters who transport patients to their appointments. Caretaker relatives means a relative of a dependent child by blood, adoption, or marriage. xml ¢ ( Ì–MOã0 †ï+ñ "_Qã®Р5åÀÇq iAâêÚ“ÖÂ_²§@ÿýN’6BPH! â )ñÌû> [™™œ=Y“=@LÚ»‚ åc– “^i7 Until such a time as the MaineCare Benefits Manual (MBM), Section 60. 454, An Act to Require Reimbursement to Department of Health and Human Services 109 Capitol Street 11 State House Station Augusta, Maine 04333. 12/19/2016 2:28 PM. 04-11); Jan 5, 2023 · MaineCare Benefits Manual, Section 97, Private Non-Medical Institution Services WORD PDF . Option 3: E-mail an application to Farmington. Following CMS Aug 23, 2023 · Notice of Agency Rule-making Proposal AGENCY: Department of Health and Human Services, MaineCare Services CHAPTER NUMBER AND TITLE: 10-144 C. 2017, ch. 0159 (MaineCare Benefits Manual, Section 21), and ME. Chapter 101, MaineCare Benefits Manual, Chapters II and III, Section 91, Health Home Services ADOPTED RULE NUMBER: CONCISE SUMMARY: This adopted rule will have a future effective date of June 21, 2022, and will not be effective five days after filing the adopted rule with the Secretary of State’s Office PK !? x Å º [Content_Types]. CHAPTER NUMBER AND TITLE: 10-144 C. Legally Effective: 9/28/22. There are limits or special rules for most covered services. Established 3-13-79. Chapter 101, MaineCare Benefits Manual, Chapter VI, Section 1, Primary Care Case Management (PCCM). 12/28/2023 10:27 AM. 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. Explore the comprehensive summary of member benefits offered by MaineCare, including coverage details and service policies. To get more information or help filling out an application, please call the Department of Human Services toll-free at: 1-877-543-7669. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 25, Dental Services (repeal) Chapter III, Section 25, Allowances for Dental Services (repeal) Chapter II, Section 25, Dental Services and Reimbursement Methodology (this Chapter 332: MaineCare Eligibility Manual. 03-3. Nov 9, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. section 65behavioral health services established: 11/09/22. MaineCare does not reimburse for shipping, handling, and related costs. Jan 22, 2024 · MaineCare Benefits Manual, Chapter II, Section 29; Comments and Responses, Chapter II, Section 29; The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. TTY users dial 711. Oct 27, 2023 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. To see if your medication is covered, call the Pharmacy Help Desk at -866-796-2463, TTY: 711. Chapter II. Dec 7, 2023 · Notice of MaineCare Reimbursement Methodology Change AGENCY: Department of Health and Human Services, Office of MaineCare Services SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 67, Nursing Facility Services NATURE OF PROPOSED CHANGES: The Department plans to submit a State Plan Amendment in the near future identifying the following: Jun 8, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. xml ¢ ( Ì–MOã0 †ï+ñ "_Qã®Р5åÀÇq iAâêÚ“ÖÂ_²§@ÿýN’6BPH! â )ñÌû> [™™œ=Y“=@LÚ»‚ åc– “^i7 Dec 4, 2023 · Dec 11, 2023. 101, MaineCare Benefits Manual, Chapter II, Section 43, Hospice Services PROPOSED RULE NUMBER: CONCISE SUMMARY: Nov 9, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. mainecare benefits manual. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. Dec 18, 2023 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. • MaineCare will not reimburse transportation time. 101, MaineCare Benefits Manual (the “MBM”), Chapter II, Section 89, MaineMOM Services and Reimbursement. Jan 13, 2023 · SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 65, Behavioral Health Services NATURE OF PROPOSED CHANGES: The Department plans to update reimbursement for tobacco cessation counseling services for non-pregnant individuals included under Section 65 – Behavioral Health Services to align with the reimbursement methodology Sep 28, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. Section 96 - Private Duty Nursing and Personal Care Services 2024. legal effective date: 11/09/22. xml ¢ ( Ì—_oÓ0 Åß‘ø ‘_Qãn „PÓ=lð “( ¯®}ÓZó?Ù·Ûúí±“&b£[R¼ ½DJìsÎïÆ–s³¸¸×ª¸ ¤5 9+ç¤Ã fS‘Ÿ«¯³O¤ ÈŒ`Ê ¨È ¹X¾}³Xí „"ªM¨È Ñ}¦4ð-h JëÀÄ‘ÚzÍ0Þú uŒß° Ðóùü#åÖ œaò ËÅ Ôl§°ør ·$ÎlHqÙÎKQ ‘:éÓszTáA…G 朒œa §·Fâš ˜Ê¨læ„tá]œðDB y:à û _¦— Škæñ Option 2: Download the MaineCare Application and mail it to: Office for Family Independence 114 Corn Shop Lane Farmington, ME 04938. CHAPTER III. Make sure MaineCare covers the service you need before you get care. See the MaineCare Benefits Manual, Chapter I, Section 1, Subsection 1. See also the site maintained by the Department of Health Under Age 1 Full MaineCare Benefit 196% $2,220 $2,991 $3,762 $4,533 $771 Newborns born to a mother receiving full MaineCare on the date the baby is born are eligible without an income test. Nov 15, 2023 · Addition of well-child visit: In response to the COVID-19 pandemic, on May 13, 2020, the Department emergency adopted MaineCare Benefits Manual, Ch. As a reminder, OMS in partnership with the Maine Centers for Disease Control and Prevention (ME CDC), developed a MaineCare policy which allows MaineCare to reimburse providers for delivering the National Diabetes Prevention Program Jan 19, 2024 · In follow up to our January 19, 2024 notice, service codes and rates for Sections 68 and 85 of the MaineCare Benefits Manual, effective January 1, 2024, are now implemented to reflect 72. Access to Your Health Information Feb 16, 2022 · Publication Date. 01 INTRODUCTION This Section of the MaineCare Benefits Manual consolidates what were previously four separate Sections; Section 58 Licensed Clinical Social Worker, Licensed Clinical Professional Counselor Dec 19, 2016 · Name. , Chapter 101, MaineCare Benefits Manual, Chapters II & III, Section 45, Hospital Services. • completing the assigned number of resident assessments in a thorough, efficient and timely manner; • maintaining confidentiality; • editing all completed MDSs for typographical errors and incorrect responses to assure accurate data entry of information into provider software; Oct 24, 2022 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. 2 The Department of Health and Human Services (the “Department”) proposes the following changes to 10-144 C. Chapter 101, MaineCare Benefits Manual, Chapter III, Section 29, Allowances for Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder PROPOSED RULE NUMBER: MaineCare Benefits MANUAL. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect Aug 23, 2023 · Notice of Agency Rule-making Proposal AGENCY: Department of Health and Human Services, MaineCare Services CHAPTER NUMBER AND TITLE: 10-144 C. 1082 (MBM Section 18). Chapter 101, MaineCare Benefits Manual (“MBM”), Chapter II, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Ch. AGENCY: Department of Health and Human Services, MaineCare Services CHAPTER NUMBER AND TITLE: 10-144 C. PK !HC { ã [Content_Types]. Mar 22, 2022 · Mar 23, 2022. MAINECARE BENEFITS MANUAL. DHHS@Maine. May 12, 2022 · May 12, 2022. This massive chapter is in Microsoft Word (. Nov 18, 2021 · Nov 18, 2021. May 20, 2022 · AGENCY: Department of Health and Human Services, MaineCare Services, Division of Policy. Here is Chapter 332, its accompanying appendices and charts, along with Chapter 333 ( Low Cost Drugs for Elderly and Disabled (DEL) ), Chapter 334 ( Maine Rx Plus ), Chapter 335 ( Health Insurance Purchase Option (HIPO) for Children under Age 19 Feb 28, 2023 · SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, Section 31, Federally Qualified Health Center Services NATURE OF PROPOSED CHANGES: The Department plans to implement an Alternative Payment Methodology (APM) effective March 1, 2023. Jun 21, 2023 · The MaineCare Benefits Manual is available on-line at the Secretary of State’s website. SECTION 67PRINCIPLES OF REIMBURSEMENT FOR NURSING FACILITIESEstablished 3-13-79. 02 ELIGIBILITY FOR CARE Individuals must meet financial eligibility as set forth in the MaineCare Eligibility Manual. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 90, Physician Services ADOPTED RULE NUMBER: CONCISE SUMMARY: This final rule makes the following changes: Oct 27, 2023 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. (800) 977-6740. Determine your eligibility for this benefit. Aug 23, 2023 · Aug 23, 2023. (MDS- ALS) in accordance with the MaineCare Benefits Manual. Option 5: Visit one of our district offices and apply in person. 06-2 for more detail about reimbursement for interpreter services. Chapter 101, MaineCare Benefits Manual, Chapter II, Section 29, Support Services for Adults with Intellectual Disabilities or Autism Spectrum Disorder Nov 21, 2023 · The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. Dec 28, 2023 · AGENCY: Department of Health and Human Services, Office of MaineCare Services SERVICES INCLUDED: Chapter 101, MaineCare Benefits Manual, January 1 Cost-of-Living Adjustments NATURE OF PROPOSED CHANGES: The Department plans to submit a state plan amendment to increase reimbursement for the Sections listed below. PRINCIPLES OF REIMBURSEMENT FOR NURSING FACILITIES. zpridminmpuyhmnysguw