[Provider] MaineCare Services Rule Making for Nursing Facilities

[Provider Notification]

ATTENTION:            MaineCare Nursing Facility Providers

 

This is notice of emergency and proposed rule making for Chapter III,
Section 67 of the MaineCare Benefits Manual, Principles of Reimbursement

for Nursing Facilities.

 

 

Emergency Rule                                            

            

Concise Summary:

In this emergency rule making, the Department is implementing changes in
the rate methodology as well as providing an additional one time payment
for the quarter between October 1, 2008 and December 31, 2008.
Specifically, the rate methodology alters the base year from 1998 to
2005.  The rule also establishes a new prospective per diem rate by
adding a direct care regional cost component and a hold harmless
provision to the rule.  Other changes are made in this rule making that
include changes in medical director costs and waiver of administrator
costs that are included under the management ceiling.  The Department
has budgeted $9,388,889 (federal and state funds) for FY '09 for this
rate methodology change. This amount is derived out of the original
$16,353,230 appropriated by the State Legislature, Public Law 2007, Ch.
240, Pt. A., after other budgetary changes were made.

 

Effective Date:

December 16, 2008 - March 15, 2009

 

 

Proposed Rule                                              

 

Concise Summary:

The Department is proposing this rule to permanently adopt the emergency
rules that went into effect on December 16, 2008.  Specifically, the
Department is proposing to change the base year that is used to
calculate direct care and routine care costs from 1998 to 2005.  In
addition, language is added to waive the principle that combines the
administrator costs and other services that an administrator may be
delivering under the Administration and Management ceiling.  This
specific change will only be applicable for single-level facilities with
forty (40) or fewer beds.  The Department also proposes language that
increases the cap for medical director costs from $1200 to $10,000.
Furthermore, the Department proposes to amend the language that
establishes the prospective per diem rate, by adding a direct care
regional cost component to the rule.  The Department also proposes to
make a one-time rate adjustment in addition to the base rate adjustment
for the time period between October 1, 2008 and December 31, 2008. A new
subsection is also added that establishes that all new NF beds converted
to Residential care beds must have a private pay source.  Other minor
technical and grammatical changes are also included in this rule
proposal. The proposed rate changes will increase expenditures for
nursing facility services by $9,388,889 (federal and state funds) for FY
'09.

 

Public Hearing:

January 12, 2009, 1:00 p.m. 

Conference Room # 1A

Department of Health and Human Services / Office of MaineCare Services

442 Civic Center Drive, Augusta, ME 

 

Any interested party requiring special arrangements to attend the
hearing must contact the agency person listed below before January 5,
2009.

 

Deadline for Comments:

Comments must be received by midnight January 22, 2009.

 

Contact:

Allyssa Morrison, MaineCare policy writer at Alyssa.morrison at maine.gov

 

Web Posting:

The emergency and proposed rule will be posted to the MaineCare Services
web site at http://www.maine.gov/dhhs/bms/rules/prov_other_rules.htm

 

 

 

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