MaineCare Notice of Agency Rule-making Proposal, MaineCare Benefits Manual, Chapters II and III, Section 43
Notice of Agency Rule-making Proposal
AGENCY: Department of Health and Human Services (DHHS), MaineCare Services, Division of Policy
CHAPTER NUMBER AND TITLE:
10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter II, Section 43, Hospice Services
10-144 C.M.R. Ch. 101, MaineCare Benefits Manual, Chapter III, Section 43, Allowances for Hospice Services
PROPOSED RULE NUMBER:
CONCISE SUMMARY: This rulemaking proposes the following changes in order to comply with various laws and add clarity.
Chapter II Rule Proposed Changes:
- Adds a requirement for Electronic Visit Verification (“EVV”). This has been approved by CMS. The Department proposes that this provider requirement be effective on January 1, 2024, in order to give providers adequate notice and time to comply.
- Amends the definition of “Attending Physician” to include nurse practitioners and physician assistants. This is consistent with Section 51006 of the Bipartisan Budget Act of 2018 (P. L. 115-123), as codified in 42 U.S.C. § 1395x(dd)(3)(B), the Medicare program.
- Adds a definition for the term “Benefit Period” which appears multiple times throughout this rule.
- Section 43.07-5 (Payment for Inpatient care): Changes the date by which Hospice providers submit inpatient data to the Department, upon Department request, from January 1st to October 1st, following the end of the period ending September 30th of the previous year, in keeping with the federal fiscal year.
- Adds Opioid Health Home Services to the list of services that may be continued after the election of hospice.
- Makes minor technical edits to improve the clarity of the rule.
- Adds a new section – Allowances for Hospice Services – which is largely moved from the Ch. III rule, which is being repealed.
Chapter III Rule Proposed Changes:
The Department proposes to repeal Ch. III, and to move the Ch. III columns describing the Revenue Code, HCPC Code and Description of Services to the Ch. II rule. The Department proposes to delete the column with the specific reimbursement rate from the rule, and will post the specific reimbursement rates on the MaineCare Fee Provider Schedule which is posted on the Department’s website, as authorized by 22 M.R.S. Sec. 3173-J(7).
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173; 42 U.S.C. § 1396b(l); 42 U.S.C. §1395x(dd)
DATE, TIME, AND PLACE OF PUBLIC HEARING: September 5, 2023, 01:00 PM Eastern Time (US and Canada)
The Department has determined that its public hearing will be hybrid, conducted both in-person and remotely, via Zoom.
Zoom Meeting link: https://mainestate.zoom.us/j/86850235189
Meeting ID: 868 5023 5189
One tap mobile: 1-646-931-3860
Find your local number: https://mainestate.zoom.us/u/kbcQF4SzvH
In addition to the public hearing, individuals may submit written comments to DHHS by the date listed in this notice.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 PM on Friday, September 15, 2023.
AGENCY CONTACT PERSON: Julieanna Scott, Comprehensive Health Planner II
AGENCY NAME: Office of MaineCare Services
ADDRESS: 109 Capitol Street, 11 State House Station
Augusta, Maine 04333-0011
TELEPHONE: 207-287-2286 FAX: (207) 287-6106
TTY: 711 (Deaf or Hard of Hearing)
IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
CONTACT PERSON FOR SMALL BUSINESS INFORMATION (if different): N/A
STATUTORY AUTHORITY FOR THIS RULE: 22 M.R.S. §§ 42, 3173 and 3173-J; 42 U.S.C. § 1396b(l) ); 42 U.S.C. §1395x(dd)
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