MaineCare Notice of Agency Waiver Amendment, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder 

Sep 12, 2024

The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage.  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 Benefits Manual is available on-line at the Secretary of State’s website. 

Below, please find a MaineCare Notice of Agency Waiver Amendment. You can access the complete details at http://www.maine.gov/dhhs/oms/rules/index.shtml.

Notice of Agency Waiver Amendment

AGENCY:  Department of Health and Human Services, MaineCare Services

RULE TITLE OR SUBJECT: Chapter 101, MaineCare Benefits Manual, Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder. 

WAIVER: ME.0159, Intellectual Disabilities or Autism Spectrum Disorder Waiver

CONCISE SUMMARY: The Department plans to submit an amendment to the Section 21, Home and Community Benefits for Members with Intellectual Disabilities or Autism Spectrum Disorder Home and Community Based Services (HCBS) 1915(c) waiver application.  This waiver amendment adjusts funding and rates to reflect the elimination of health care services from the Maine State Service Provider Tax in accordance with 36 M.R.S. § 2552, effective January 1, 2025.

Effective January 1, 2025, Section 21 services for which the Department has documentation that the cost of the current 6% Maine State Service Provider Tax (SPT) (36 M.R.S. § 2552) has been built into the rates will receive a corresponding 6% rate reduction to comply with PL 2023, ch 412, An Act Making Unified Appropriations and Allocations from the General Fund and Other Funds for the Expenditures of State Government and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2023, June 30, 2024 and June 30, 2025.

The impacted services and corresponding codes in Section 21 include:

Procedure Code	Modifier	Description
T2015		Career Planning, per Hour
T2016		Agency Home Support, per Hour
T2016	SC	Agency Home Support, Med Add On, per Hour
T2017		Home Support, 15 Min
T2017	SC	Home Support, Med Add On, 15 Min
T2017	QC	Home Support, Remote, Monitor, 15 Min
T2017	GT	Home Support, Remote, Interactive, 15 Min
T2019		Employment Specialist, 15 Min
T2019	SC	Employment Specialist, Med Add On, 15 Min
T2021		Community Support, 15 Min
T2021	SC	Community Support, Med Add On, 15 Min
T2021	UA	Community Support, Individual, 15 Min
T2021	UB	Community Support, Group, 15 Min
H2023		Work Support-Individual, 15 Min
H2023	SC	Work Support Med Add On-Individual, 15 Min

 

Please see the accompanying draft application for a complete list of all proposed changes included in the amendment. 

DHHS is accepting comments through 11:59 pm, October 11, 2024. Any interested party may obtain a copy of the waiver application by going to the website noted below or at any regional Office for Family Independence (a list of the offices and locations can be found at this link http://www.maine.gov/dhhs/ofi/offices/index.html).

A printed copy may be obtained by calling Lisa Weaver at (207) 624-4050 or emailing:lisa.weaver@maine.gov.

See http://www.maine.gov/dhhs/oms/rules/index.shtml for waiver amendment and to submit comments.

STATUTORY AUTHORITY:            42 CFR §441.304

DEADLINE FOR COMMENTS:      Comments must be received by 11:59 pm, October 11, 2024.

AGENCY CONTACT PERSON:       Heather Bingelis, Comprehensive Health Planner II

AGENCY NAME:                              MaineCare Services

ADDRESS:                                         109 Capitol Street, State House Station # 11

                                                           Augusta, Maine 04333-0011

EMAIL                                               Heather.bingelis@maine.gov

TELEPHONE:207-624-4951 FAX: (207) 287-1864 TTY: 711