[Provider] Adopted Rule for Chapter 115

[Provider Notification]

ATTENTION:  All MaineCare Providers of Residential Care Facilities

 

This message is to give notice that a rule has been adopted for Chapter
115 of the MaineCare Benefits Manual.  This is for Principles of
Reimbursement for Residential Care Facilities - Road and Board Costs.
Adopted rules are final and no changes can be made at this point.

 

Concise Summary:   

This final rule permanently adopts an emergency rule eliminating a
restriction on reimbursement for bedhold days in those instances where
an associated PNMI treatment cost has not been billed under MaineCare.
The rule change removes language in Chapter 115, Principles of
Reimbursement for Residential Care Facilities.  In a separate
rulemaking, the Department has eliminated reimbursement for Private
Non-Medical Institution (PNMI) bedhold days for those days reimbursed by
the MaineCare program.  Providers billing for PNMI services under
Appendices C and F will still be able to bill up to thirty (30) bedhold
days per calendar year when a member is absent from the facility.  The
codes used for this billing continue to be reimbursed with the billing
codes "BL" and "MRBL." This will allow for continued reimbursement of
some routine fixed costs that are not eliminated when the member is
temporarily absent from the facility.  These funds are reimbursed by all
state dollars, and are not matched with reimbursement from the federal
Medicaid program.  Compliance with this rule change is not anticipated
to impose additional administrative costs on small businesses.

 

Effective Date:   

October 30, 2008

 

Agency Contact Person:

Patricia Dushuttle

 

Agency Name:    

Office of MaineCare Services

 

Mailing Address:   

442 Civic Center Drive

11 State House Station

Augusta, Maine  04333-0011

 

Telephone:

207-287-9362 

FAX: (207) 287-9369

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

 

 

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

 

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