[Provider] MaineCare Podiatry Changes Effective October 1

[Provider Notification]

ATTENTION:  All MaineCare Providers of Podiatry Services

 

To achieve savings as required by the Maine State Legislature, MaineCare
has made changes to MaineCare Benefits Manual, Chapter II, Section 90,
Physician Services & Section 95, Podiatry Services regarding prior
authorization. 

 

After an initial visit, all foot and ankle care services will only be
covered for a member who meets the following medical eligibility
requirements with supporting documentation:

1.	Has any illness, diagnosis, or condition that if left unattended
may cause loss of function or may risk loss of limb; AND
2.	For whom self-care or foot care by a nonprofessional person
would be hazardous and pose a threat to the member's condition.

 

Several procedures now require prior authorization.  A complete listing
is posted on the MaineCare internet and can be found at

 

http://www.maine.gov/bms/member/innerthird/mecms_portal_news.html#podiat
ry

 

Also please note that procedure code 28890 - High Energy ESWT, plantar
fasciitis, will NO LONGER be a MaineCare covered service as of October
1, 2008.  This decision was made after finding the data inconclusive to
support the use of ESWT for the treatment of plantar fasciitis.

 

 

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

 

 

 

 

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