[Provider] Emergency Rules
Provider Notification
provider at lists.maine.gov
Wed Dec 31 16:22:25 EST 2008
Below are four emergency adopted rules which go into effect this week.
CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapter III, Section 22, Home and Community Benefits for the Physically Disabled
CONCISE SUMMARY: This rule making immediately adopts a rate change for Personal Care Attendant Services by changing the rate from $2.28 to $2.57 per quarter hour. This rate change is necessary to comply with the federal requirements governing the recently submitted waiver amendment that governs this program. This waiver amendment defines a new institutional level of care which allows for a higher rate of reimbursement for personal care attendant services under this section. Permanent changes will be contingent upon CMS approval.
EFFECTIVE DATE: December 31, 2008 - March 30, 2009
AGENCY CONTACT PERSON: Alyssa Morrison, Health Planner
TELEPHONE: (207)-287-9368 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
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CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapter III, Section 19, Home and Community Benefits for the Elderly and Adults with Disabilities
CONCISE SUMMARY: This emergency rule adopts a rate reduction for the comprehensive care management service listed under this section. Specifically, the rate is being reduced to $126.50 per month from $139.00 per month. This is written in the approved budget curtailment which expects to save $62,600 in the General Fund in SFY 09 as a result of this rate change. This rule making is not expected to impose administrative costs on small businesses, counties or municipalities.
EFFECTIVE DATE: January 1, 2009 - March 31, 2009
AGENCY CONTACT PERSON: Alyssa Morrison, Health Planner
TELEPHONE: (207)-287-9368 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
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CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapter 101, Ch II, Section 90, Physician's Services
CONCISE SUMMARY: Pursuant to 5 M.R.S.A. Sec 8054, effective December 29, 2008, the Department is increasing the MaineCare reimbursement rate for non-hospital based physician services from 53% to 56.94% retroactive to July 1, 2008. This increase will not include reimbursement for procedures performed by radiologists, radiation oncologists, and pathologists, who currently receive a higher rate of reimbursement. No procedure codes are decreased as a result of this rulemaking. Furthermore, this increase does not apply to other sections of policy within the MaineCare Benefits Manual, Chapter 101. This emergency rule will remain in effect for 90 days while the Department promulgates rules to permanently adopt this rate change.
No adverse impact on small businesses is anticipated from adoption of this rule.
EFFECTIVE DATE: December 29, 2008
AGENCY CONTACT PERSON: Nicole Rooney, Health Planner
TELEPHONE: (207)-287-9368 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
AGENCY: Department of Health and Human Services, Office of MaineCare Services
CHAPTER NUMBER AND TITLE: Maine State Services Manual, Chapter 104, Section 4, Maine Part D Wrap Benefits
ADOPTED RULE NUMBER:
CONCISE SUMMARY: In order to comply with the federal guidelines that determine the Part D Benefit parameters, the member co-payment for generic drugs has increased from $2.25 to $2.40 per prescription. This emergency rule is required to comply with federal guidelines. The Part D Wrap Benefit covers this co-payment for eligible beneficiaries. The new co-pay amount is reflected in the Appendix to this rule.
This rule change is not expected to impose administrative costs on small businesses.
See http://www.maine.gov/bms/rules/provider_rules_policies.htm for rules and related rulemaking documents.
EFFECTIVE DATE: January 1, 2009
AGENCY CONTACT PERSON: Nicole Rooney, Health Planner
AGENCY NAME: Division of Policy
ADDRESS: 442 Civic Center Drive
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: (207)-287-4460 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
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CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapters II & III, Section 29, Community Support Benefits for members with Mental Retardation and Autistic Disorder
CONCISE SUMMARY: The adopted rule eliminates the Behavioral Add On and reduces the rate of the Medical Add On.
EFFECTIVE DATE: January 1, 2009
AGENCY CONTACT PERSON: Ginger Roberts-Scott, Comprehensive Health Planner
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing
CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapter II, Section 21, Home and Community Benefits for members with Mental Retardation or Autistic Disorder
CONCISE SUMMARY: The adopted emergency rules reduce rates for Home Support. Also, rates for the Medical Add On for Community Support, Employment Specialist Services and Work Support are being reduced. Additionally, this rule creates an additional level of support for Home Support Shared Living, and Home Support Family Centered Support Model. Also, the Behavioral Add On has been removed from all services. Lastly, Intensive Family Centered Support has been eliminated as a type of Home Support.
EFFECTIVE DATE: January 1, 2009
AGENCY CONTACT PERSON: Ginger Roberts-Scott, Comprehensive Health Planner
AGENCY NAME: Division of Policy and Performance Services
ADDRESS: 442 Civic Center Drive
11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: (207)-287-9365 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
CHAPTER NUMBER AND TITLE: MaineCare Benefits Manual, Chapter III, Section 21, Home and Community Benefits for members with Mental Retardation or Autistic Disorder
CONCISE SUMMARY: The adopted emergency rules reduce rates for Home Support. Also, rates for the Medical Add On for Community Support, Employment Specialist Services and Work Support are being reduced. Additionally, this rule creates an additional level of support for Home Support Shared Living, and Home Support Family Centered Support Model. Also, the Behavioral Add On has been removed from all services. Lastly, Intensive Family Centered Support has been eliminated as a type of Home Support. Members currently receiving Intensive Family Centered Support will continue to receive increased Family Centered Support with the new regulations until the Department makes a determination under the criteria set forth in Section 21, Chapter II, 21.14 Appendix I.
EFFECTIVE DATE: January 1, 2009
AGENCY CONTACT PERSON: Ginger Roberts-Scott, Comprehensive Health Planner
TELEPHONE: (207)-287-9365 FAX: (207) 287-9369
TTY: 1-800-423-4331 or 207-287-1828 (Deaf/Hard of Hearing)
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