[Provider] MaineCare Adopted Rule

[Provider Notification]

ATTENTION:  All MaineCare Providers of Physician Services

 

CHAPTER NUMBER AND TITLE:  

MaineCare Benefits Manual, Chapter II, Section 90, Physician Services

 

CONCISE SUMMARY:  

This rule adopts changes to Chapter II, Section 90, Physician Services,
sub section 90.04-7, that improve the guidelines and process for
reimbursement. The adopted rule states that MaineCare will not reimburse
for physician administered drugs that are not rebateable under Centers
for

Medicare and Medicaid Services (CMS) regulation unless the physician
obtains Prior Authorization (PA). PA will not be granted for
non-rebateable, physician administered drugs for which there are
therapeutically equivalent alternatives that are rebateable.  

 

EFFECTIVE DATE:                          

April 1, 2008

 

AGENCY CONTACT PERSON:  

Scott Goulette, Comprehensive Health Planner

 

TELEPHONE:            207-287-9370 

FAX:                            207-287-9369 

TTY:                            1-800-423-4331 or 207-287-1828 (Deaf or
Hard of Hearing)

 

A listing of proposed, emergency and recently adopted rules can be found
on the MaineCare Services web site at:

http://www.maine.gov/dhhs/bms/rules/provider_mcare_benefit.htm

 

 

This is a one-way communication.  Please do not respond to this message.

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