November 23, 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: 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 (MBM): Ch. III Section 18, Allowances for Home and Community Based Services for Adults with Brain Injury
ADOPTED RULE NUMBER: 2016-P178
CONCISE SUMMARY: The Department is proposing a 1% increase to certain rates in Ch. III Section 18 in accordance with PL 2016 ch. 477 (An Act to Increase Payments to MaineCare Providers That Are Subject to Maine’s Service Provider Tax), which provides additional appropriations to certain MaineCare providers who are subject to the service provider tax and who have experienced a recent increase in the tax from 5% to 6%. The Legislature enacted this law as an emergency measure, effective April 15, 2016, recognizing that providers affected by the tax increase had insufficient reserves to withstand this cost increase and that immediate funding was necessary to enable providers to continue providing MaineCare services. The Department adopted changes to this rule on an emergency basis with the increased rates effective retroactive to April 15, 2016.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
PUBLIC HEARING: December 12, 2016 - 11:00 a.m., 19 Union Street, Conference Room 110, Augusta Maine. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 2, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 p.m. on December 22, 2016.
AGENCY CONTACT PERSON / SMALL BUSINESS INFORMATION: Rachel Posner, Comprehensive Health Planner II, MaineCare Services, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-6951. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). E-mail: Rachel.Posner@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rule-making will not have any impact on municipalities or counties.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS    42, 42(8), 3173; 5 MRS  8054; PL 2016 ch. 477 (effective April 15, 2016)
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
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) – Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual (MBM: Ch. II and III Section 19, Title: Home and Community Benefits for the Elderly and Adults with Disabilities.
PROPOSED RULE NUMBER: 2016-P179
CONCISE SUMMARY: This rule is being proposed in order to comply with LD 886, Resolve, Directing the Department of Health and Human Services To Increase Reimbursement Rates for Home-based and Community-based Services.
Ch. II Section 19 was originally promulgated to provide members with the opportunity to remain in their own homes, avoiding or delaying institutional care. Ch. III is the companion rule to Ch. II and provides billing codes and rates for the services described in Ch. II.
In this proposed rule-making, the Department is adding “person-centered” language, clarifying language for “Budget Authority,” and adding new services to this rule that will provide members with additional opportunities to obtain necessary supports and services within their communities. The Department is concurrently proposing Ch. III Section 19, adding procedure codes for the newly added services in Ch. II Section 19.
The Department is also proposing to increase rates in Ch. III in accordance with LD 886, Resolve, Directing the Department of Health and Human Services To Increase Reimbursement Rates for Home-based and Community-based Services. The Legislature passed LD 886 to authorize an increase in rates to reflect 50% of the change in rates noted in the final rates modeled in the February 1, 2016 report, “Rate Review for Personal Care and Related Services: Final Rate Models,” prepared for the Department by Burns & Associates, Inc. The rate increase will be retroactive to July 29, 2016. Providers will need to ensure that they are using the appropriate procedure code, modifier, and revenue code for reimbursement of services.
The Department is proposing this rule (1) to add person-centered language due to CMS guidance; (2) to add clarifying language to ensure that the State would not be considered a third party employer for members’ attendants hired through the Participant Directed Option; (3) to add three new services: Home Delivered Meals, Living Well (Chronic Disease Management) and Matter of Balance (Falls Prevention) to enhance members opportunities to access necessary supports and services within their communities, avoiding or delaying the need for institutional level of care and, (4) the Department is concurrently proposing Ch. III Section 19 adding New Procedure Codes for the newly added services in Ch. II Section 19 and to comply with LD 886.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
PUBLIC HEARING: December 13, 2016 - 9:00 a.m., 19 Union Street - Conference Room 110, Augusta Maine. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 1, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 p.m. on December 23, 2016
AGENCY CONTACT PERSON / SMALL BUSINESS INFORMATION: Rachel Posner, Ph.D., Comprehensive Health Planner II, MaineCare Services, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-6951. Fax: (207) 287-1864, TTY: 711 (Deaf or Hard of Hearing). E-mail: Rachel.Posner@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rule-making will not have any impact on municipalities or counties.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS    42, 3173
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

AGENCY: 10-148 - Department of Health and Human Services (DHHS), Office of Child and Family Services (OCFS)
CHAPTER NUMBER AND TITLE: Ch. 201, Procedures for the Abuse or Neglect Substantiation Process, for Appeals for Persons Substantiated as Perpetrators of Abuse or Neglect of Children, and Appeals for Denial of Access to Confidential Records
PROPOSED RULE NUMBER: 2016-P180
BRIEF SUMMARY: These rules are being proposed to ensure that individuals who are substantiated for child abuse or neglect and are facing collateral consequences have the opportunity to appeal that substantiation. In addition, these rules are proposed to ensure that individuals being denied access to their child's record have the ability to appeal the Department's denial of said records.
PUBLIC HEARING: No hearing will be held.
COMMENT DEADLINE: December 23, 2016
CONTACT PERSON FOR THIS FILING / SMALL BUSINESS INFORMATION: Debra White, Hearings and Appeals Unit – OCFS, 11 State House Station, Augusta, ME 04333. Telephone: (207) 624- 7968. E-mail: Debra.White@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: no fiscal impact anticipated.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS    42, 4004(2)(C-l), 4008(7), 5601-5610; PL 2015 ch. 501.
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OCFS WEBSITE: http://www.maine.gov/dhhs/ocfs/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .

ADOPTIONS

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 (MBM): Ch. II & III Section 31, Federally Qualified Health Center Centers
ADOPTED RULE NUMBER: 2016-194
CONCISE SUMMARY: This rule amends the rate setting and rate-adjustment processes for the prospective payment system (PPS) used to reimburse Federally Qualified Health Centers (FQHCs).
This rule-making clarifies and expands the current FQHC policy and procedures as follows:
* Provides additional guidance and consistency in the methodology for adjustments of PPS rates;
* Amends the process of rate establishment for newly qualifying FQHCs;
* Provides specific guidance in what constitutes a “change in scope” of services; and
* Expands the reporting requirements in conjunction with a request for rate adjustment due to a “change in scope” of services.
* Additional changes to the rule include broadening the tobacco cessation treatment services to comply with 22 MRS  3174-WW, and expanding current contraceptive coverage to include all federally approved intrauterine devices.
The Centers for Medicare and Medicaid Services (“CMS”) has approved a Maine State Plan Amendment related to initial rate-setting and “change in scope” of services. The payment methodology for FQHCs conforms to Section 702 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: December 1, 2016
AGENCY CONTACT PERSON: Anne Labonte Perreault, Comprehensive Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4082. Fax: (207) 287-1864. TTY users call Maine relay 711. E-mail: Anne.Labonte-Perreault@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) – Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual (MBM): Ch. II & III Section 103, Rural Health Clinic Services
ADOPTED RULE NUMBER: 2016-195
CONCISE SUMMARY: This rule amends the rate setting and rate-adjustment processes for the Prospective Payment System (PPS) used to reimburse Rural Health Clinic Services (RHCs).
This rule-making clarifies and expands the current RHC policy and procedures as follows:
* Provides additional guidance in the methodology for adjustments of PPS rates;
* Amends the process of rate establishment for newly qualifying RHCs;
* Provides specific guidance in what constitutes “a change in scope of services”; and
* Expands the reporting requirements to support requests for rate adjustments due to a change in scope of services.
* Additional changes to the rule include broadening the tobacco cessation treatment services to comply with 22 MRS  3174-WW, and expanding current contraceptive coverage to include all federally approved intrauterine devices.
The Centers for Medicare and Medicaid Services (“CMS”) has approved a Maine State Plan Amendment related to initial rate-setting and “change in scope of services.” The payment methodology for RHCs conforms to Section 702 of the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act (BIPA) of 2000.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: December 1, 2016
AGENCY CONTACT PERSON: Anne Labonte Perreault, Comprehensive Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4082. Fax: (207) 287-1864. TTY users call Maine relay 711. E-mail: Anne.Labonte-Perreault@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) – Division of Policy
CHAPTER NUMBER AND TITLE: Ch. 101, MaineCare Benefits Manual (MBM): Ch. III Section 18, Allowances for Home and Community Based Services for Adults with Brain Injury
ADOPTED RULE NUMBER: 2016-196 (Emergency)
CONCISE SUMMARY: The Department is adopting via emergency rule-making a 1% increase to certain rates in Ch. III Section 18 in accordance with PL 2016 ch. 477 (An Act to Increase Payments to MaineCare Providers That Are Subject to Maine’s Service Provider Tax), which provides additional appropriations to certain MaineCare providers that are subject to the service provider tax and that have experienced a recent increase in the tax from 5% to 6%. The Legislature enacted this law as an emergency measure, effective April 15, 2016, recognizing that providers affected by the tax increase had insufficient reserves to withstand this cost increase and that immediate funding was necessary to enable providers to continue providing MaineCare services. As set forth in the Basis Statement, the Department adopts changes to this rule on an emergency basis with the increased rates effective retroactive to April 15, 2016.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: November 15, 2016
AGENCY CONTACT PERSON: Andrew Hardy, Comprehensive Health Planner, Division of Policy, 242 State Street, 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4058. Fax: (207) 287-1864. TTY users call Maine relay 711. E-mail: Andrew.Hardy@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 for Family Independence (OFI)
CHAPTER NUMBER AND TITLE: Ch. 301, Food Supplement Program Manual, FS Rule #194A: Section FS-444-12, Households with Special Circumstances (Lottery Winnings)
ADOPTED RULE NUMBER: 2016-197
CONCISE SUMMARY: The rule creates a basis for termination of benefits based on substantial lottery and/or gambling winnings. The current manual does not address lottery/gambling winnings and their effect on eligibility. The rule causes immediate termination of benefits when anyone in the benefit household has received lottery/gambling winnings of $5,000.00 or more (after any offsets to the winnings required by law) in one calendar month. Affected households may immediately reapply, and will be subject to eligibility guidelines to requalify, including to any applicable asset test. The Department may coordinate with the Maine Lottery Commission in implementing this rule to receive confirmation of significant winnings.
See http://www.maine.gov/dhhs/ofi/rules/index.shtml for rules and related rule-making documents.
EFFECTIVE DATE: November 21, 2016
AGENCY CONTACT PERSON: Marta Noriega-Allen, Senior Planner, Office for Family Independence, Department of Health & Human Services, 19 Union Street, Augusta, ME 04333. Telephone: (207) 624-4135. Fax: (207) 287-3455. TT Users Call Maine Relay – 711. E-mail: Marta.Noriega-Allen@Maine.gov .
OFI WEBSITE: http://www.maine.gov/dhhs/ofi/ .
DHHS RULE-MAKING LIAISON: Kevin.Wells@Maine.gov .