[Provider] Adopted Rules: Medical Supplies and Durable Medical Equipment Section 60

[Provider Notification]

This message is to give notice that rules have been adopted for Ch. 101,
MaineCare Benefits Manual, Chapter II, Section 60, Medical Supplies and
Durable Medical Equipment 

 

Adopted rules are final and no changes can be made at this point.

 

CONCISE SUMMARY:  The adopted rules reflect changes to repeal and
replace Section 60 in order to clarify the policy and to achieve
legislatively mandated cost savings.  Proposed changes include new
language under Limitations, additional prior authorization requirements,
and new language to clarify that items procured under a contract with
the Department must be purchased, billed and reimbursed according to the
terms of the contract.  This Section has been totally replaced due to
extensive formatting changes, including a thorough restructuring of the
Appendix.  

 

Changes made to the Section 60 proposed rule based on the State budget
include:  increasing the markup of the acquisition cost of DME to 40%
from 30%, and DME providers must deduct any prompt payment discounts
when determining the acquisition cost of DME.  Several additional
changes were made to clarify the Section 60 proposed rule due to
comments received and legal review, such as; sleep studies for CPAP and
Bi-Pap done within the last three (3) years will be accepted; limits for
incontinent supplies for members under 21 were removed; and the time to
obtain a written prescription for a Power Mobility Device was changed to
45 days.

 

The adopted rule does not impose an economic burden on municipalities or
counties.  The adopted rules are not expected to increase reporting,
record keeping, or other administrative costs or skills necessary for
reporting or recording for small businesses.  

 

See  http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html
for rules and related rulemaking documents.

 

EFFECTIVE DATE:                   July 1, 2009

 

AGENCY CONTACT PERSON:  Darrell S. Wood, Health Planner

      AGENCY NAME:                        Division of Policy and
Performance

      ADDRESS:                                   442 Civic Center Drive

                                                            11 State
House Station

                                                            Augusta,
Maine 04333-0011

      TELEPHONE:                             (207)-287-6348, FAX: (207)
287-9369

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

________________________________________________________________________
______

 

The Division of Policy posts all proposed and recently adopted rules
<http://www.maine.gov/bms/rules/provider_rules_policies.htm>  on
MaineCare's website.  This website keeps the proposed rules on file
until they are finalized and until the Secretary of State website is
updated to reflect the changes.  The MaineCare Benefit Manual is
available on-line at the Secretary of State's website
<http://www.maine.gov/sos/cec/rules/10/ch101.htm> .  

 

 

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This is a one-way communication.  Do not reply to this e-mail.  Your
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