February 17, 2016

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: 09-137 – Department of Inland Fisheries and Wildlife (IFW)
CHAPTER NUMBER AND TITLE: Ch. 20, Taxidermy License
PROPOSED RULE NUMBER: 2016-P015
BRIEF SUMMARY: The Commissioner of Inland Fisheries and Wildlife is proposing to amend taxidermy license rules to update language and formatting, specify criteria and establish record keeping and completion requirements for current license holders. The Department is proposing to add language that will require current taxidermy license holders to adhere to the same competency standards as applicants when work is performed for customers or they may be held incompetent or negligent in the practice of taxidermy.
A complete copy of the proposal can be obtained from the Agency Rulemaking Contact Person listed below.
PUBLIC HEARING: None scheduled, one may be requested.
COMMENT DEADLINE: March 18, 2016
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION / IFW RULE-MAKING LIAISON: Becky Orff, Inland Fisheries & Wildlife, 284 State Street, 41 State House Station, Augusta, ME 04333. Telephone: (207) 287-5202. E-mail: Becky.Orff@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: None anticipated.
STATUTORY AUTHORITY FOR THIS RULE: 12 MRSA  § § 12952 & 12953
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
WEBSITE: http://www.maine.gov/ifw/ .

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services – Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual (MBM): Ch. II Section 90, Physician Services
PROPOSED RULE NUMBER: 2016-P016
CONCISE SUMMARY:
* The rule-making allows for unlimited coverage of comprehensive tobacco cessation treatment for all members who wish to cease the use of tobacco. These changes to Section 90 will be effective retroactive to August 1, 2014, for members eighteen (18) years of age or older or who are pregnant, in compliance with LD 386, An Act to Reduce Tobacco-related Illness and Lower Health Care Costs in MaineCare (22 MRSA  §3174-WW).
* This rule-making adds coverage for oral evaluation by a medical provider for a child under the age of three (3) who does not have a dental home and/or has not seen a dentist in the past year. This rule-making also amends language for coverage of topical application of fluoride varnish to align with limits described in MBM, Ch. III Section 25, “Dental Services”.
* The Department proposes to remove the limits of five (5) services in any consecutive seven (7) day period and eight (8) emergency therapy visits “per emergency” for no more than two (2) hours within a single twenty-four (24) hour period.
* This rule-making removes the requirement that providers delivering psychiatric services within their scope of licensure and state law must be under direct supervision of a board eligible or certified psychiatrist. This rule also renames “Psychiatric Services,” to “Behavioral Health Services.”
* This rule-making amends the anesthesia time unit used for billing anesthesia services to one (1) minute intervals, rather than fifteen (15) minutes, in order to comply with Health Insurance Portability and Accountability Act (HIPPA) Version 5010.
* This rule-making clarifies (i) the limit to the number of patients that the anesthesiologist or operating physicians may supervise as a maximum of four (4) patients concurrently, (ii) the service and billing instructions for medically-directed services for physicians; and, (iii) that post-anesthesia care is a requirement of anesthesiology services.
* The time periods indicated in surgical services for post-operative treatment are amended to comply with the Centers for Medicare and Medicaid Services (“CMS”) standard fee schedule for durational global surgical periods.
* To align with the Early Periodic Screening, Diagnosis, Treatment Program (EPSDT), providers are no longer required to submit Well Child Visit (“Bright Futures”) forms in order to receive MaineCare reimbursement for services. In addition, language in this rulemaking clarifies that participation in EPSDT is optional and that providers are not required to complete a specific rider to deliver covered preventive health services.
* This rule-making amends provider qualifications for obstetrical services to ensure that any appropriately licensed or certified, qualified professional working within their scope of licensure or certification may deliver obstetrical services to MaineCare members. Requirements around hospital admitting privileges are also amended: in order to deliver obstetrical services, providers must personally, or through a formal arrangement, have active hospital admitting privileges to an approved MaineCare hospital which includes maternity services.
* This rule-making updates the methods by which the Department sets rates in the MaineCare Fee Schedule to include an option to obtain an average from other state Medicaid agencies for relevant codes when the code is not priced by Medicare.
* The rule-making also increases the reimbursement of primary care physicians for certain primary care services. This initiative replaces expiring funds provided through the federal Patient Protection and Affordable Care Act (ACA), P.L. 111-148. CMS has approved a Maine State Plan Amendment for this program, effective January 1, 2015. PL 2015 ch. 267 (702 – LD 109), Part A approved continued funding of this program, and the Section 90 policy will be updated to reflect the full initiative (an effective date of January 1, 2015). Eligible providers are those practicing with a specialty designation of Family Medicine, Internal Medicine, or Pediatric Medicine or with a subspecialty within these three primary care categories that is recognized by the American Board of Medical Specialties, the American Board of Physician Specialties, or the American Osteopathic Association. Eligibility for the increase is limited to qualified physicians and Advanced Practice Registered Nurses and Physician Assistants practicing under their direct supervision. Hospital-based physicians and physicians providing services as part of a Federally Qualified Health Center or Rural Health Clinic remain ineligible.
* This rule-making moves specific entries under “Covered Services” that describe procedural information, including “Insurance Coverage - Insurance Benefit,” to Section 90.09-2, “Reimbursement”.
* This rule-making clarifies Section 90.09-3, “Reimbursement Rate for Drugs Administered By Other Than Oral Methods”, without any change in coverage, reimbursement or procedures.
* This rule-making deletes the separate “Computerized Axial Tomography Scan” subsection under covered services and includes the same information in 90.04-6, “Medical Imaging Services”.
* This rule-making states that audiologists, physical therapists, and occupational therapists must follow the expectations and limitations in their applicable sections of policy when rendering services in a physician’s practice.
* For consistency with Section 1.03-2, which provides that MaineCare will not provide payment to any entity outside the United States, and as required by Section 6505 of the Patient Protection and Affordable Care Act, P.L. 111-148 (March 23, 2010), the following language has been removed from the policy: “or province” from multiple locations.
* This rule-making also includes other minor and technical changes, such as updating website links, updating language to be consistent with other MaineCare materials, spelling out acronyms, updating names of government agencies, and updating titles of MBM sections.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
PUBLIC HEARING: March 7, 2016 - 9:00 a.m. - Conference Room 110, Department of Health and Human Services, 19 Union Street, Augusta, Maine 04333. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before 5:00 p.m., on Monday, February 29, 2016.
DEADLINE FOR COMMENTS: Comments must be received by midnight Thursday, March 17, 2016.
AGENCY CONTACT PERSON: Olivia Alford, Comprehensive Health Planner II, MaineCare Services, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4059. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). E-mail: Olivia.Alford@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department does not anticipate that this rule-making will have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS  § § 42, 3173; 22 MRS  § 3174-WW; PL 2015 ch. 267 Part A; Patient Protection and Affordable Care Act, P.L. 111-148, Section 6505
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

ADOPTIONS

AGENCY: 29-255 – Secretary of State, Maine State Archives
CHAPTER NUMBER AND TITLE: Ch. 10, Rules for Disposition of Local Government Records
ADOPTED RULE NUMBER: 2016-020
CONCISE SUMMARY: Public Law 2011 ch. 58 amended Maine’s vital records law, MRSA 22  §2706, placing restrictions on who can obtain vital records, specifically records of births, deaths and marriages.
Before a vital record can be released, an applicant must provide proof that they are either related to the registrant or they have a direct and legitimate interest in the matter recorded. This rule is being amended to bring it into compliance with law.
EFFECTIVE DATE: February 9, 2016
AGENCY CONTACT PERSON / ARCHIVES RULE-MAKING LIAISON: Tammy Marks, Maine State Archives, 230 State Street, 84 State House Station, Augusta, ME 04330. Telephone: (207) 287-5799. E-mail: Tammy.Marks@Maine.gov .
WEBSITE: http://www.maine.gov/sos/arc/ .

AGENCY: 02-031 - Department of Professional and Financial Regulation (PFR), Bureau of Insurance
CHAPTER NUMBER AND TITLE: Ch. 545, Producer and Business Entity License and Appointment Fees (Amendment)
ADOPTED RULE NUMBER: 2016-021
CONCISE SUMMARY: This amendment reduces license fees paid by resident and nonresident insurance producers.
EFFECTIVE DATE: February 13, 2016
AGENCY CONTACT PERSON: Elena Crowley, Maine Bureau of Insurance, 34 State House Station, Augusta, ME 04333-0034. Telephone: (207) 624-8421. E-mail: Elena.I.Crowley@Maine.gov .
WEBSITE: http://www.maine.gov/pfr/insurance/
INSURANCE RULE-MAKING LIAISON: Thomas.M.Record@Maine.gov .

AGENCY: 02-032 - Department of Professional and Financial Regulation (PFR), Office of Securities
CHAPTER NUMBER AND TITLE: Ch. 528, Federal “Regulation A” Tier 2 Notice Filings and Fees (New)
ADOPTED RULE NUMBER: 2016-022
CONCISE SUMMARY: This rule creates a notice filing requirement and a filing fee for securities offered in Maine under Tier 2 of federal Regulation A. As a result, the Maine Office of Securities will have notice and a record of these offerings, enhancing Maine investors’ access to information about the offerings and supporting the Office’s investigative and enforcement authorities related to the offerings.
EFFECTIVE DATE: February 15, 2016
AGENCY CONTACT PERSON: Judith M. Shaw, Administrator, Office of Securities, 121 State House Station, Augusta, ME 04333-0121. Telephone: (207) 624-8551. E-mail: Judith.M.Shaw@Maine.gov .
WEBSITE: http://www.maine.gov/pfr/securities/index.shtml .
SECURITIES RULE-MAKING LIAISON: Karla.Black@Maine.gov .

< AGENCY: 94-270 - Commission on Governmental Ethics and Election Practices
CHAPTER NUMBER AND TITLE: Ch. 1, Procedures
ADOPTED RULE NUMBER: 2016-023
CONCISE SUMMARY: The rule amendments implement a new disclosure requirement for communications advocating for or against candidates to include the top three funders of the organization paying for the communication, and adjusts the filing schedule for independent expenditure reports.
EFFECTIVE DATE: February 16, 2016
AGENCY CONTACT PERSON: Commission Assistant, Commission on Governmental Ethics and Election Practices, 135 State House Station, Augusta, Maine 04333-0135. Telephone: (207) 287-3024. E-mail: Ethics@Maine.gov .
WEBSITE: http://www.maine.gov/ethics/ .
ETHICS RULE-MAKING LIAISON: Jonathan.Wayne@Maine.gov .

AGENCY: 10-144 - Department of Health and Human Services (DHHS), Office of MaineCare Services (OMS) – Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual: Ch. III Section 67, Principles of Reimbursement for Nursing Facilities
ADOPTED RULE NUMBER: 2016-024
CONCISE SUMMARY: The Department adopts this rule to effectuate the following changes:
(1) Increase the final prospective per diem rate to be paid to each facility by increasing the reimbursement calculation, excluding fixed costs, from 95.12 percent to 97.44 percent of all of the calculated direct care cost components and all of the routine cost components; and
(2) Include the cost of continuing education for direct care staff as a direct care cost component rather than a routine cost component.
These changes are in accordance with Public Law 2015 ch. 267, Part A, and Resolves 2015 ch. 34, Resolve, To Implement the Recommendations of the Commission to Continue the Study of Long-term Care Facilities. If the Centers for Medicare and Medicaid Services approves, these changes will be effective retroactive to July 1, 2015.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: February 15, 2016
AGENCY CONTACT PERSON: Heidi Bechard, Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4074. Fax: (207) 287-1864. TTY: 711 (Deaf/Hard of Hearing). E-mail: Heidi.Bechard@Maine.gov .
WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .