June 10, 2015

WEEKLY NOTICES OF STATE RULE-MAKING
Public Input for Proposed and Adopted Rules

Notices are published each Wednesday to alert the public regarding state agency rule-making. You may obtain a copy of any rule by notifying the agency contact person. You may also comment on the rule, and/or attend the public hearing. If no hearing is scheduled, you may request one -- the agency may then schedule a hearing, and must do so if 5 or more persons request it. If you are disabled or need special services to attend a hearing, please notify the agency contact person at least 7 days prior to it. Petitions: you can petition an agency to adopt, amend, or repeal any rule; the agency must provide you with petition forms, and must respond to your petition within 60 days. The agency must enter rule-making if the petition is signed by 150 or more registered voters, and may begin rule-making if there are fewer. You can also petition the Legislature to review a rule; the Executive Director of the Legislative Council (115 State House Station, Augusta, ME 04333, phone 207/287-1615) will provide you with the necessary petition forms. The appropriate legislative committee will review a rule upon receipt of a petition from 100 or more registered voters, or from "...any person who may be directly, substantially and adversely affected by the application of a rule..." (Title 5 Section 11112). World-Wide Web: Copies of the weekly notices and the full texts of adopted rule chapters may be found on the internet at: http://www.maine.gov/sos/cec/rules. There is also a list of rule-making liaisons, who are single points of contact for each agency.

PROPOSALS

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office for Family Independence (OFI)
CHAPTER NUMBER AND TITLE: Ch. 332, MaineCare Eligibility Manual, Rule #280P: Part 18 (New), Presumptive Eligibility Determined by Hospitals
PROPOSED RULE NUMBER: 2015-P083
BRIEF SUMMARY: This rule implements a requirement in the Affordable Care Act that allows hospitals to make presumptive MaineCare eligibility decisions for parents/caretaker relatives, children age 18 and younger, pregnant women, certain former foster care children, and certain individuals needing treatment for breast or cervical cancer. The rule establishes requirements hospitals must follow when making presumptive eligibility determinations and confirms the populations eligible for presumptive eligibility determinations.
PUBLIC HEARING: June 30, 2015, 10:00 a.m. at 19 Union Street, Conference Room 110, Augusta, ME
COMMENT DEADLINE: July 13, 2015
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION: R.W. Bansmer, Jr., MaineCare Senior Program Manager, Office for Family Independence, 11 State House Station, Augusta, ME 04333. Telephone: (207) 624-4105. TTY: 711 Maine Relay. E-mail: Reinhold.Bansmer@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: None anticipated
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS  § § 42(1), 3173; 42 CFR 435.1110
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED: Not applicable
WEBSITE: http://www.maine.gov/dhhs/ofi/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .


AGENCY: 90-351 - Workers’ Compensation Board
RULE TITLE OR SUBJECT:
Ch. 5, Medical Fees; Reimbursement Levels; Reporting Requirements (repeal and replace)
Ch. 12, Formal Hearings (amend)
Ch. 17, Expenses and Fees (amend)
PROPOSED RULE NUMBERS: 2015-P084 thru P086
CONCISE SUMMARY: Pursuant to 39-A MRSA  §209-A(5), every three years the Board must undertake a comprehensive review of the medical fee schedule. The proposed incorporates changes designed to ensure both broad access to care and appropriate limitations on the cost of health care services.
PUBLIC HEARING: Monday, June 29, 2015, 9:00 a.m., Workers' Compensation Board, Central Office, AMHI Complex, Deering Building, First Floor, Room 170, Hospital Street, Augusta, Maine
DEADLINE FOR COMMENTS: July 9, 2015
AGENCY CONTACT PERSON / SMALL BUSINESS INFORMATION / BOARD RULE-MAKING LIAISON: John Rohde, General Counsel, Workers’ Compensation Board, 27 State House Station, Augusta ME 04333-0027. Telephone: (207) 287-7086. E-mail: John.Rohde@Maine.gov .
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY: 39-A MRSA  §101 et seq.
WEBSITE: http://www.maine.gov/wcb/ .


AGENCY: 13-188 - Department of Marine Resources (DMR)
RULE TITLE OR SUBJECT: Ch. 34, Groundfish Regulations: Recreational Cod and Haddock Federal Compliance
PROPOSED RULE NUMBER: 2015-P087
CONCISE SUMMARY: In accordance with the New England Fisheries Management Council and for consistency with the National Marine Fisheries Service (NMFS) federal regulations effective May 1, 2015, the Department enacted emergency rule-making for charter, party and recreational fishing vessels operating in state waters regarding cod and haddock. For the recreational fishery, the cod fishery has been closed and it is now unlawful to take or possess cod in state waters. For recreational haddock fishing, the minimum size is now reduced to 17 inches to reduce mortality. This rule-making would make that emergency rule-making permanent.
PUBLIC HEARINGS: None scheduled.
DEADLINE FOR COMMENTS: July 10, 2015. To ensure consideration, comments must include your name and the organization you represent, if any. Please be aware that any risk of non-delivery associated with submissions by fax or e-mail is on the sender.
AGENCY CONTACT PERSON: Bruce Joule (207-633-9505). Mail written comments to attn: Deirdre Gilbert, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6576. Fax: (207) 624-6024. TTY: (888) 577-6690 (Deaf/Hard of Hearing). E-mail: dmr.rulemaking@maine.gov . DMR Rule-making Website: http://www.maine.gov/dmr/rulemaking/ .
THIS RULE WILL NOT HAVE A FISCAL IMPACT ON MUNICIPALITIES.
STATUTORY AUTHORITY: 12 MRS  §6171
DMR WEBSITE: http://www.maine.gov/dmr/index.htm .


AGENCY: 99-346 - Maine State Housing Authority (MSHA)
CHAPTER NUMBER AND TITLE: Ch. 24, Home Energy Assistance Program
PROPOSED RULE NUMBER: 2015-P088
BRIEF SUMMARY: This rule repeals and replaces the current Home Energy Assistance Program rule. The replacement rule (i) adds new definitions and clarifies existing definitions, (ii) deletes references to the Social Security Administration database verification process (iii) establishes new guidelines for HEAP funded weatherization activities in place of the U.S. Department of Energy Weatherization Assistance Program guidelines; (iv) revises procurement guidelines for heating system repairs and replacements; (v) clarifies eligibility criteria for a Household that includes a member who is a non-qualified alien; (vi) clarifies eligibility and response times for Energy Crisis Intervention Program; (vii) expands the eligibility for Central Heating Improvement Program services to allow for the replacement and repair of inefficient Heating Systems and preventative cleaning, tuning and evaluation of Heating Systems; (viii) increases the life-time maximum CHIP benefit for a Dwelling Unit to $5,000 for owner occupied units and $400 for rental units; (ix) includes MaineHousing’s right to debar community action participation for malfeasance; and (x) makes other minor modifications, clarifications, grammatical changes, and formatting improvements.
A copy of the proposed replacement rule may be found at www.mainehousing.org. Upon sufficient notice, this notice and the proposed rule will be made available in alternative formats for persons with disabilities and in alternative languages for persons with limited English proficiency.
PUBLIC HEARING: A public hearing will be held on Tuesday, June 30, 2015 at 9:30 a.m. at Maine State Housing, 353 Water Street, Augusta, Maine 04330-4633. Maine State Housing Authority’s office and the hearing room are accessible to persons with disabilities and, upon sufficient notice, appropriate communications auxiliary aids and services will be provided to persons with disabilities and persons with limited English proficiency.
COMMENT DEADLINE: Friday, July 10, 2015 at 5:00 p.m.
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION / MSHA RULE-MAKING LIAISON: Linda Uhl, Chief Counsel, Maine State Housing Authority, State House Station #89, 353 Water Street, Augusta, Maine 04330-4633 Telephone: (207) 626-4600; (800) 452-4668 (voice in state only); or Maine Relay 711. E-mail: luhl@mainehousing.org .
IMPACT ON MUNICIPALITIES OR COUNTIES: None
STATUTORY AUTHORITY FOR THIS RULE: 30-A MRSA  § § 4722(1)(W), 4741(15), 4991 et seq.; 42 U.S.C.A.  § § 8621 et seq.
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED: Same as above
WEBSITE: www.mainehousing.org .

ADOPTIONS

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services (OMS)
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual: Ch. II & III Section 35, Hearing Aids and Services (Repeal)
ADOPTED RULE NUMBER: 2015-106
CONCISE SUMMARY: Pending the approval by the Centers for Medicare and Medicaid Services (CMS), the adoption of this rule will repeal Section 35, “Hearing Aids and Services”, Ch. II & III. The services covered under this section will transition to Ch. II Section 60, “Medical Supplies and Durable Medical Equipment”. In addition, all reimbursement rates will be set forth per the fee schedule located at the following website: http://www.maine.gov/dhhs/audit/rate-setting/documents/S60MedSuppandDME_002.pdf .
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: June 13, 2015
AGENCY CONTACT PERSON: Debbie Walsh, Comprehensive Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 287-1068. Fax: (207) 287-9369. TTY: 711 (Deaf/Hard of Hearing). E-mail: Debbie.Walsh@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .


AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services (OMS)
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual: Ch. II Section 60, Medical Supplies and Durable Medical Equipment
ADOPTED RULE NUMBER: 2015-107
CONCISE SUMMARY: The Department amends several sections of Ch. 101, MaineCare Benefits Manual, Ch. II Section 60, “Medical Supplies and Durable Medical Equipment” (DME). The changes adopted in this rule-making maintain or increase the level of services available to members.
These changes include the addition of medically necessary hearing aids as a covered service for members age twenty-one (21) and older, the inclusion of hearing aid services for members under age twenty-one (21) in Section 60, and coverage for medically necessary Continuous Glucose Monitors (CGM). The Department makes these changes in order to assure that members have access to the most appropriate cost effective treatment available. In order to assure minimal changes to providers currently providing hearing aids, the Department adds an exemption to the provider requirements listed in Section 60.01-12 (C), stating that audiologists are not required to maintain a storefront.
In addition, this rule adoption replaces all references to the term “Mentally Retarded” or “MR” with “Individual with Intellectual Disability” or “IID” as required by P.L. 2012 ch. 542  §B (5), An Act to Implement the Recommendations of the Department of Health and Human Services and the Maine Developmental Disabilities Council Regarding Respectful Language.
The Department also replaced the term: “Authorized Agent” with the term “Authorized Entity.” This change is being adopted across the agency in order to more accurately describe the Department’s relationship with the aforementioned entities. Contractors with the state are not legal agents of the state, so the term was replaced with “entity” to avoid confusion.
The Department also increased the limits for orthopedic modifications and inserts classified with HCPCS Level II codes as Medical and Surgical Supplies (i.e. diabetic shoes, fittings and modifications), as identified in Section 60.07-1(A), to allow eligible members to receive up to a combined total of six (6) units of modifications and/or inserts per year. This change was made to maintain consistency with established Medicare limits.
Additionally, the Department made a number of technical changes in an effort to provide clarity and eliminate duplicative language. These changes include the following:
1. The list of equipment under Section 60.05-13 Medical Supplies and DME not covered for Members in a Nursing Facility (NF) or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID), have been reorganized and defined to provide clarity (no equipment has been added or eliminated);
2. Definitions for the terms Aesthetic or Deluxe Durable Medical Equipment, Hearings Aids and Prior Authorization have been added to the definition section;
3. The term “store” has been revised to “storefront” in Section 60.01-12(C) in order to assure consistency with other language within this section;
4. Website addresses have been updated to assure accuracy; and,
5. To be consistent with Section 1.03-2 which provides that MaineCare will not provide payment to any entity outside the United States, and is required by Section 6505 of the Patient Protection and Affordable Care Act, P.L. 111-148 (March 23, 2010) the following language will be removed from the policy: “or within five (5) miles of the Maine border in Canada”.
Following the rule proposal, the Department conducted a public hearing on February 2, 2015. Comments were received through February 12, 2015. As a result of the public comments, the following additional changes were made to the rule:
1. The Department clarified the provisions affecting the replacement of hearing aids by inserting the word “all” in the heading for Section 60.05-8(A) so that the rule reads: “Replacement of all DME is allowed for the following reasons . . .”; and by reformatting a subsection (B) with the title “Additional Rules for Hearing Aids.”
2. To clarify the face-to-face encounter requirements under Section 60.05, the Department deleted the word “physician’s” before “written orders” and added a sentence to make clear that the physician, physician assistant, nurse practitioner, or clinical nurse specialist who performs the face-to-face encounter may also write the prescription for the DME.
3. In Section 60.12, Appendix I, part (K)(2), the Department added criteria for MaineCare members under twenty-one (21) years old to receive binaural hearing aids which tracks the criteria for this member population to receive monaural hearing aids.
4. The Department corrected the criteria found in Section 60.12, Appendix I, part (Y)(1)(e)(vi) and (Y)(2)(f)(vi) to read: “Patient with HgbA1c > 7.5 . . .” instead of “< 7.5.”
5. The Department replaced the word “prosthetics” with “prosthetist” in Section 60.12, Appendix I, part (L).
6. Where necessary, the Department clarified the two affected age groups under this Section: (1) under twenty-one (21) years old and (2) age twenty-one and over.
7. Consistent with the face-to-face encounter requirements at Section 60.05, the Department inserted the word “Physician” and replaced the term “Certified Nursing Assistant” with “Clinical Nurse Specialist” in Section 60.05-1(J) as provider types who can perform the encounter.
8. Corrections have been made to the numbering format in Section 60.12, Appendix I, part (Y).
Concurrent with this adoption, the Department is also repealing MaineCare Benefits Manual, Ch. II and III Section 35, “Hearing Aids and Services”. The Section 60 rule adoption and the Section 35 rule repeal are dependent upon approval to the Medicaid State Plan by the Centers for Medicare and Medicaid Services (CMS).
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: June 13, 2015
AGENCY CONTACT PERSON: Debbie Walsh, Comprehensive Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 287-1068. Fax: (207) 287-9369. TTY: 711 (Deaf/Hard of Hearing). E-mail: Debbie.Walsh@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .