[Provider] Update on Rule-Making for MaineCare Benefits Manual Section 13, Targeted Case Management

[Provider Notification]

Attention:  All MaineCare Providers of Targeted Case Management

 

As providers know, the Department has been working on a revision of MBM
Section 13, Targeted Case Management.  The intent is to simplify the
rule and to clearly define those who are eligible to receive case
management services.  Those eligible include Children with Developmental
Disabilities and Behavioral Health Disorders, Adults with Developmental
Disabilities, Behavioral Health Disorders, Substance Abuse Disorders,
HIV, and Long Term Care Needs and any member experiencing homelessness. 

 

The rule will require prior authorization and utilization review for
children's targeted case management.  This rule will also clarify that
MaineCare will not cover duplicative services and it will set forth the
requirement for MaineCare members to transition to one comprehensive
case manager. 

 

This rule will not be proposed for a July 1, 2009 emergency
implementation, as previously discussed.  However, the Department
continues its work on this rule-making and anticipates the rule will be
proposed, still for emergency implementation, within the first two weeks
of July. 

 

Questions regarding this rule-making can be directed to
Melanie.Miller at maine.gov or Kathy.Bubar at maine.gov

 

 

Is your mailing address up to date with MaineCare?  Please keep
MaineCare up to date so your Remittance Statements and checks arrive on
time.  Call Provider Enrollment at 1-800-321-5557 Option #6.  

 

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This is a one-way communication.  Do not reply to this e-mail.  Your
e-mail will not receive response.  If you have questions, please call

1-800-321-5557.

 

 

 

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