[Provider] Proposed rules: Adults with Physical Disabilities, Hospital Services, Nursing Facilities
Provider Notification
provider at lists.maine.gov
Tue Jul 28 08:40:28 EDT 2009
This is notice of recently proposed rules. Proposed rules are issued to
the public for review and comment. These rules may change before
finally adopted.
Section 22 Home and Community Benefits for Adults with Physical
Disabilities
Section 45 Hospital Services
Section 67 Nursing Facilities
Rule Title Or Subject: Chapter 101, MaineCare Benefits Manual, Chapter
III, Section 22, Home and Community Benefits for Adults with Physical
Disabilities
Concise Summary: The Department proposes to adjust the rates for
personal care attendant services under this section. Specifically, the
proposal increases the rate from $2.57 to $2.61 per fifteen minutes.
This is being proposed because the rate that was adopted in March 2009
did not adjust for the total amount of state funds allocated for the
program. In order to claim full Federal match for this program, this
rate needs to be adjusted an additional four cents. In addition, this
rate is now consistent with the personal care attendant rates reimbursed
under Section 12 of the MaineCare Benefits Manual.
See http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html
for rules and related rulemaking documents.
Public Hearing: August 17th at 1 PM
Location: Conference Room # 4
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 August 10,
2009.
Deadline For Comments: Comments must be received by midnight August 27,
2009
Agency Contact Person: Alyssa Morrison, Health Planner
Agency name: Office Of MaineCare Services
Address: 442 Civic Center Drive
11 State House Station
Augusta, Maine 04333-0011
Telephone: 207-287-9368 FAX: (207) 287-9369 TTY: 1-800-423-4331 or
207-287-1828 (Deaf or Hard of Hearing)
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Rule Title Or Subject: Chapter 101, MaineCare Benefits Manual, Chapter
III, Section 45, Hospital Services
Concise Summary: The Department is proposing to permanently adopt
emergency rules currently in place that reduce hospital reimbursement.
As mandated by the Legislature, in P.L. 2009, ch. 213, Part CC,
effective July 1, 2009 the Department reduced hospital reimbursement.
For acute care non-critical access hospitals, inpatient discharge rates
(except for those from psychiatric units) were reduced 6.7% and
reimbursement for outpatient services was decreased to 83.8% of costs.
For critical access hospitals and hospitals reclassified to a wage area
outside Maine, reimbursement for inpatient and outpatient services was
reduced to 109% of costs. For all acute care hospitals, including
critical access, hospital based physician reimbursement was decreased
from 100% to 93.3% of allowable costs for inpatient non-emergency
physicians, to 93.4% of costs for inpatient emergency physicians and to
83.8% of costs for outpatient non-emergency physicians.
In addition, these emergency rules eliminated the COLA adjustment for
SFY's 2010 and 2011 for non critical access acute care hospitals for
inpatient discharge rate and for psychiatric unit discharge rates. The
Department capped the PIP payment so that the total payment to all
hospitals is not less than 80%. All of the above mentioned changes are
contingent upon approval from CMS.
See http://www.maine.gov/bms/rules/provider_rules_policies.htm for
rules and related rulemaking documents or visit your local DHHS agency
where this rule proposal can be accessed for you.
Public Hearing: August 19, 2009, 1 p.m.
Location: Conference Room # 3
Department of Health and Human Services
Office of MaineCare Services
442 Civic Center Drive
Augusta, ME 04330
Any interested party requiring special arrangements to attend the
hearing must contact the agency person listed below before August 10,
2009.
Deadline For Comments: Comments must be received by midnight, August 31,
2009.
Agency Contact Person: Derrick Grant, Comprehensive Health Planner
Agency Name: Office of MaineCare Services
Address: 442 Civic Center Drive
11 State House Station
Augusta, Maine 04333-0011
Telephone: 207-287-6427 FAX: (207) 287-9369 TTY: 1-800-423-4331 or
207-287-1828 (Deaf or Hard of Hearing)
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Rule Title Or Subject: Chapter 101, MaineCare Benefits Manual, Chapter
III, Section 67, Principles of Reimbursement for Nursing Facilities
Concise Summary: The Department is proposing to permanently adopt
emergency rules that became effective July 1, 2009. Specific proposed
changes include: revisions of dates and methodology used to trend
forward or inflate direct care and routine costs, updating the percent
of the median used in the July 1, 2009 rebasing calculation, and
clarifying the direct care add-on and hold harmless principles. In
addition, the Department is proposing the one-time payment methodology,
which is already approved by CMS. Furthermore, this proposal includes a
new principle that identifies the methodology used to establish rates
for remote island facilities. Other minor and technical changes are
considered in this rule making.
See http://www.maine.gov/dhhs/oms/rules/provider_rules_policies.html
for rules and related rulemaking documents.
Public hearing: August 26, 2009, 1 PM
Location: Conference Room # 3
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 August 16,
2009.
Deadline For Comments: Comments must be received by midnight, September
6, 2009.
Agency Contact Person: Alyssa Morrison, Health Planner
Agency Name: Office of MaineCare Services
Address: 11 State House Station
Augusta, Maine 04333-0011
Telephone: 207-287-9368 FAX: (207) 287-9369 TTY: 1-800-423-4331 or
207-287-1828 (Deaf or Hard of Hearing
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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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