November 28, 2018

WEEKLY NOTICES OF STATE RULEMAKING
Public Input for Proposed and Adopted Rules

Notices are published each Wednesday to alert the public regarding state agency rulemaking. 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 rulemaking if the petition is signed by 150 or more registered voters, and may begin rulemaking 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 rulemaking 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 13, Allowances for Targeted Case Management
PROPOSED RULE NUMBER: 2018-P264
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) proposes this rule to increase the rates of reimbursement for targeted case management services pursuant to PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (the “Act”), Part D.
The Act requires the Department to amend its rules for reimbursement rates for targeted case management services provided under the provisions of 10-144 CMR ch. 101, MaineCare Benefits Manual, Ch. III Section 13, “Allowances for Targeted Case Management”.
Specific changes are as follows:

  • Part D of PL 2017 ch. 460 directs the Department to increase the rate of reimbursement for all services by two percent. Sec. D-1 and D-2 specifically require the increase in reimbursement to be applied to the wages and benefits of employees who provide direct services and not to administrators or managers.

Through the Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 13 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates will be effective August 1, 2018; this date comports with the federal law requirement. Pending approval of the proposed changes to the Section 13 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed eight calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the Act and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not an effective rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: December 18 - 9:00 a.m., 32 Blossom Lane, Marquardt Building Door D7, Augusta, ME 04333. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed above before December 12, 2018.
COMMENT DEADLINE: Comments must be received by 11:59 p.m. on December 28, 2018
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Dean Bugaj, Comprehensive Health Planner II, MaineCare Services, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4045. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Dean.Bugaj@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS §§ 42(8), 3173; PL 2017 ch. 460 Part D
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 17, Allowances for Community Support Services
PROPOSED RULE NUMBER: 2018-P265
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) proposes this rule to increase the rates of reimbursement for Community Support Services pursuant to PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (the “Act”), Part D.
The Act requires the Department to amend its rules for reimbursement rates for Community Support Services provided under the provisions of 10-144 CMR Ch. 101, MaineCare Benefits Manual, Ch. III Section 17, “Allowances for Community Support Services”.
Specific changes are as follows:

  • Part D of PL 2017 ch. 460 directs the Department to increase the rate of reimbursement for all services by two percent. Sec. D-1 and D-2 specifically require the increase in reimbursement to be applied to the wages and benefits of employees who provide direct services and not to administrators or managers.

Through the Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 17 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates will be effective August 1, 2018; this date comports with the federal law requirement. Pending approval of the proposed changes to the Section 17 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed eight calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the Act and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not an effective rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: December 18 - 12:00 p.m., 32 Blossom Lane, Marquardt Building Door D7, Augusta, ME 04333. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed above before December 12, 2018.
COMMENT DEADLINE: Comments must be received by 11:59 p.m. on December 28, 2018
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Dean Bugaj, Comprehensive Health Planner II, MaineCare Services, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4045. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Dean.Bugaj@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS §§ 42(8), 3173; PL 2017 ch. 460 Part D
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 97, Private Non-Medical Institution Services, and Appendices B, C, D, E, F
PROPOSED RULE NUMBER: 2018-P266
CONCISE SUMMARY: These proposed major substantive rule changes comply with (1) PL 2017 ch. 304, An Act to Amend Principles of Reimbursement for Residential Care Facilities (“The First Act”), and (2) PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (“The Second Act”). The First Act defines the process by which an eligible Private Non-Medical Institution (PNMI) Services provider may request an Extraordinary Circumstances Allowance (ECA) and allows for certain regulatory compliance costs incurred by PNMI providers to be considered reasonable and necessary; these changes are implemented in Appendices C and F. The Second Act increases reimbursement for Appendices B, C, and E PNMIs. The Department also adopts various other changes to the Section 97 rules, including Appendix D, as described more specifically below.
The Second Act, Section B-4, requires the Department to amend the main rule and Appendix C to provide a special supplemental allowance (as more specifically set forth in the rules) for the fiscal year ending June 30, 2019. This allowance must be provided for increases in wages and wage-related benefits for direct care and personal care services cost components. The Second Act also directs that, for fiscal year ending June 30, 2020 and thereafter, the Appendix C MaineCare payment rates attributable to wages and salaries in each cost component must be increased by an inflation factor in accordance with the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index medical care services index from the prior December for professional services, nursing home, and adult day care services. In addition, the Department added a provision to Appendix C, Sec. 2400.3 to make clear that the increases in reimbursement required by the Second Act shall not be included in the PNMI facility’s personal care services cost cap.
The Second Act, Part D, requires the Department to amend the Main Rule, and Appendices B and E, to increase reimbursement rates to ensure a net increase in funding of two percent (as specifically set forth in the rules), which reimbursement must be applied to wages and benefits for employees who provide direct services and not to administrators or managers. The Second Act further requires that Section 97 providers must demonstrate to the Department that the increase in wages and benefits has been granted to direct care workers; as stated in the rules, providers must retain documents reflecting compliance with this requirement in their financial records and provide such documentation to the Department upon request.
Through the Second Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Second Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 97 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates in Appendices B, C, and E will be effective August 1, 2018, this effective date comports with the federal law requirement. Pending approval of the proposed changes to the Section 97 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates in Appendices B, C, and E will be implemented with an August 1, 2018 effective date.
To remedy the difference between the July 1, 2018 effective date set forth in the Second Act, and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for these services into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not a rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
In addition to the changes required by the First and Second Acts, other changes include but are not limited to:

  • Procedure codes: S9484 and corresponding modifiers HA, HE, and HI for Temporary High Intensity Services, per report per hours, are added to Appendices D, E, and F to more effectively align with the current prior authorization process.
  • Temporary High Intensity Staffing Services are reimbursed based on individual member’s direct care price. This direct care is not subject to audit. The Temporary High Intensity Staffing Services remittances received will be removed from the total Direct Services Staff costs in determining the allowable cost for the PNMI rehabilitation and personal care direct service staff cost.
  • The Department will calculate each Appendix C PNMI’s rate setting case mix index using the number of MaineCare residents in each case mix classification group in the facility as of March 1st for the July rate and September 1st for the January rate. The changes are adopted in order to issue rate letters to providers in a timely manner.
  • The Department will send a roster of Appendix C residents and source of payment as of March 1st and September 1st to facilities for verification prior to rate setting.

Pursuant to 5 MRS §8073, these major substantive rules were also filed as emergency rules and will remain in effect for up to one year or until the Legislature reviews the provisionally adopted rule, followed by the Department’s final adoption of the major substantive rule changes.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: December 17, 2018 - 10:00 a.m., Cross Office Building - Room 400 (This is a fragrance-free environment), 111 Sewall Street, Augusta, ME 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 12, 2018.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 p.m. on December 27, 2018.
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Heidi Bechard, Comprehensive Health Planner II, Office of MaineCare Services, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4074. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Heidi.Bechard@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that these rules will not have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS §§ 42, 3173; PL 2017 ch. 304; PL 2017 ch. 460
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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. 115, Principles of Reimbursement for Residential Care Facilities – Room and Board Costs
PROPOSED RULE NUMBER: 2018-P267
CONCISE SUMMARY: These proposed rule changes to 10-144 Ch. 115, Principles of Reimbursement for Residential Care Facilities – Room and Board Costs, comply with (1) PL 2017 ch. 304, An Act to Amend Principles of Reimbursement for Residential Care Facilities (“The First Act”), and(2)PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (“The Second Act”).

I. The First Act requires the following changes:

      • Section 20.5 – New Construction, Acquisitions, and Renovations involving capital expenditures is updated to $500,000 from $350,000.
      • A residential care facility that experiences an unforeseen and uncontrollable event during a year which results in unforeseen or uncontrollable increases in expenses may request an adjustment to a prospective rate in the form of an extraordinary circumstance allowance.
      • Costs incurred by residential care facilities to comply with changes in federal or state laws, regulations and rules, or local ordinances and not otherwise specified in rules adopted by the Department shall be considered reasonable and necessary. Reimbursement for additional regulatory costs shall be paid via a supplemental payment that is added to the per diem rate until the Department adjusts the routine limit, as applicable, to fairly and properly reimburse facilities for these costs.
These changes shall have a retroactive effective date of November 1, 2017.

II. The Second Act requires the following changes:

  • Effective August 1, 2018, for the state fiscal year ending June 30, 2019, a special supplemental allowance must be made to provide for increases in wages and wage-related benefits in the routine cost component for Appendix C PNMIs. An amount equal to ten percent (10%) of wages and associated benefits and taxes in the routine cost component as reported on each facility’s as-filed cost report for its fiscal year ending in calendar year 2016 must be added to the cost per resident day in calculating each facility’s prospective rate, notwithstanding any otherwise applicable caps or limits on reimbursement. This supplemental allowance must be allowed and paid at a final audit to the full extent that it does not cause reimbursement to exceed the facility’s allowable cost per day in the routine cost component in that fiscal year.
  • For the state fiscal year ending June 30, 2020 and each year thereafter, the payment rates attributable to wages and salaries for routine services costs for Appendix C PNMIs must be increased by an inflation factor in accordance with the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index – medical care services index from the prior December for professional services, nursing home and adult day care services.

These changes shall have a retroactive effective date of August 1, 2018.
In addition to the changes required by the First and Second Act, other changes include, but are not limited to:
• Calculating depreciation recapture for residential care facilities that have been sold, the calculation of the credits for buildings and fixed equipment will be from the date the owner began operating the facility with the original license.
• For sales of residential care facilities, moveable equipment will accumulate credits as follows: for the first four years, the asset is placed into service, all but ten percent (10%) per year will be recaptured, and from the fifth (5th) and sixth (6th) years, all but thirty percent (30%) per year will be recaptured, not to exceed one hundred percent (100%). The calculation of the credits for moveable equipment will be from the date the asset is placed into service by the provider.
• Defines moveable equipment credit accumulation and calculation for residential care facilities that have been sold.
• The following definitions have been added or clarified: Licensed Capacity, Occupancy Level, Proper Interest, and Swap Investments.
• Computer hardware may be considered a capital cost; the Department will not consider software purchase or upgrades as an allowable capital expenditure. Computer software and associated ongoing support costs fall under Routine Costs, 30.1.3.
• Office names have been updated and/or inserted to provide clarity.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: December 17, 2018 - 1:00 p.m., Cross Office Building - Room 400 (This is a fragrance-free environment), 111 Sewall Street, Augusta, ME 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 12, 2018.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 p.m. on December 27, 2018.
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Heidi Bechard, Comprehensive Health Planner II, Office of MaineCare Services, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4074. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Heidi.Bechard@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
STATUTORY AUTHORITY FOR THIS RULE: 22 MRS §§ 42, 3173, 7861(4); PL 2017 ch. 304, An Act to Amend Principles of Reimbursement for Residential Care Facilities;PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government.
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 2, Adult Family Care Services
PROPOSED RULE NUMBER: 2018-P268
CONCISE SUMMARY: The Department proposes this rule pursuant to PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (the “Act”), Part B-2. The Act requires the Department to amend its rules to increase reimbursement rates for adult family services, adult day services, and homemaker services for the fiscal year ending June 30, 2019, by ten percent (10%); and directs that MaineCare payment rates for state fiscal year ending June 30, 2020 and each year thereafter be increased by an inflation adjustment cost-of-living percentage in accordance with the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index medical care services index from the prior December for professional services, nursing home and adult day care services. These cost of living increases shall continue annually until the Department has completed a rate study for adult family care services and the rates in the rate study have been implemented.
This rulemaking increases the rates for Adult Family Care Homes and Adult Family Care Homes “Remote Island”. The Act requires that the increased rates must be attributed directly to the wages and salaries of the professional staff delivering the personal care and related services to members. This rulemaking also clarifies that the increased reimbursement rates shall not negatively affect members’ caps on services. As such, the Department implements changes in Ch. II Section 2, Sections 2.05-2 and 2.05-3 to clarify that the increased reimbursement provided herein shall not be counted towards members’ financial caps for services until Section 96 or under the waiver programs.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: Monday, December 17, 2018, at 1:00 p.m., Room 300, Burton Cross Building, 111 Sewall Street, Augusta, ME 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 10, 2018.
COMMENT DEADLINE: Comments must be received by 11:59 p.m. on December 27, 2018.
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Anne E. Labonte, Comprehensive Health Planner II, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4082. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Anne.Labonte@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS §§ 42, 3173; PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government Part B-2
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 26, Day Health Services
PROPOSED RULE NUMBER: 2018-P269
CONCISE SUMMARY: The Department proposes this rule pursuant to PL 2017 ch. 46, Part B-2, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government. Part B-2 requires the Department to amend its rules to increase reimbursement rates for adult family services, adult day services, and homemaker services for the fiscal year ending June 30, 2019, by ten percent (10%). Part B-2 also requires that effective July 1, 2019, payment rats attributable to wages and salaries for personal care and related services will be increased annually by an inflation adjustment cost-of-living percentage in accordance with the United States Department of labor, Bureau of Labor Statistics Consumer Price Index, Medical care services (professional services, nursing home and adult day care services) from the prior December. These cost of living increases shall continue annually until the Department has completed a rate study for adult family care services, adult day services or homemaker services and the rates in the rate study have been implemented.
This rule increases the rate for S5100 HC, Day Care Services.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
PUBLIC HEARING: Monday, December 17, 2018, at 2:30 p.m., Room 300, Burton Cross Building, 111 Sewall Street, Augusta, ME 04330. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before December 10, 2018.
COMMENT DEADLINE: Comments must be received by 11:59 p.m. on December 27, 2018.
OMS CONTACT PERSON / SMALL BUSINESS IMPACT INFORMATION: Anne E. Labonte, Comprehensive Health Planner II, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4082. Fax: (207) 287-1864. TTY: 711 (Deaf or Hard of Hearing). Email: Anne.Labonte@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rulemaking will not have any impact on municipalities or counties.
STATUTORY AUTHORITY: 22 MRS §§ 42, 3173; PL 2017 ch. 460 Part B-2, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED (if different):
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING LIAISON: Kevin.Wells@Maine.gov .

AGENCY: 99-346 - Maine State Housing Authority (MaineHousing)
CHAPTER NUMBER AND TITLE: Ch. 29, Multi-family Mortgage Loans
PROPOSED RULE NUMBER: 2018-P270
BRIEF SUMMARY: The proposed rule repeals and replaces the current Multi-family Development and Supportive Housing Loans and Grants rule with the Multi-family Mortgage Loans rule. The rule provides the framework and basic requirements for MaineHousing multi-family lending programs.
A copy of the proposed replacement rule may be found at www.mainehousing.org.
PUBLIC HEARING: A public hearing will be held on Tuesday, December 18, 2018 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, December 28, 2018 at 5:00 p.m.
CONTACT PERSON FOR THIS FILING/ SMALL BUSINESS IMPACT INFORMATION / MAINEHOUSING RULEMAKING LIAISON: Linda Uhl, Chief Counsel, Maine State Housing Authority, 89 State House Station - 353 Water Street, Augusta, Maine 04330-4633. Telephone: (207) 626-4600; (800) 452-4668 (voice in state only); or Maine Relay 711. Email: luhl@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.
IMPACT ON MUNICIPALITIES OR COUNTIES: None
STATUTORY AUTHORITY FOR THIS RULE: 30-A MRS §§ 4722(1)(W), 4741(15), and 4991 et seq.; 42 USCA §§ 8621 et seq.
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED: Same as above
MAINEHOUSING WEBSITE: http://www.mainehousing.org/ .

AGENCY: 99-346 - Maine State Housing Authority (MaineHousing)
CHAPTER NUMBER AND TITLE: Ch. 34, Preservation and Relocation Rule
PROPOSED RULE NUMBER: 2018-P271
BRIEF SUMMARY: Under the Maine Housing Authorities Act, a landlord who plans to take an action that would result in the termination of financial assistance for tenants in low income housing must give notice to the tenants, to Maine State Housing Authority (MaineHousing), and to any local housing authority; and give a right of first refusal to MaineHousing. This rule sets forth the required content of the notices, a mechanism for determining MaineHousing’s purchase price, and the terms of relocation assistance to help displaced tenants.
A copy of the proposed rule may be found at www.mainehousing.org.
PUBLIC HEARING: A public hearing will be held on Tuesday, December 18, 2018 at 10:00 a.m. at Maine State Housing, 353 Water Street, Augusta, Maine 04330-4633. The hearing room is 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, December 28, 2018 at 5:00 p.m.
CONTACT PERSON FOR THIS FILING/ SMALL BUSINESS IMPACT INFORMATION / MAINEHOUSING RULEMAKING LIAISON: Linda Uhl, Chief Counsel, Maine State Housing Authority, 89 State House Station - 353 Water Street, Augusta, Maine 04330-4633. Telephone: (207) 626-4600; (800) 452-4668 (voice in state only); or Maine Relay 711. Email: luhl@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.
IMPACT ON MUNICIPALITIES OR COUNTIES: None
STATUTORY AUTHORITY FOR THIS RULE: 30-A MRS §§ 4741(1), and 4973
SUBSTANTIVE STATE OR FEDERAL LAW BEING IMPLEMENTED: Same as above
MAINEHOUSING WEBSITE: http://www.mainehousing.org/ .

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. III Section 13, Allowances for Targeted Case Management
ADOPTED RULE NUMBER: 2018-248 (Emergency)
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts this emergency rule to increase the rates of reimbursement for targeted case management services pursuant to PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (the “Act”), Part D.
The Act requires the Department to amend its rules for reimbursement rates for targeted case management services provided under the provisions of 10-144 CMR Ch. 101, MaineCare Benefits Manual, Ch. III Section 13, “Allowances for Targeted Case Management”.
Specific changes are as follows:

  • Part D of PL 2017, ch. 460 directs the Department to increase the rate of reimbursement for all services by two percent. Sec. D-1 and D-2 specifically require the increase in reimbursement to be applied to the wages and benefits of employees who provide direct services and not to administrators or managers.

Through the Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 13 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates will be effective August 1, 2018; this date comports with the federal law requirement. Pending approval of the proposed changes to the Section 13 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed eight calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the Act and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not an effective rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
Pursuant to 5 MRS §8054, this emergency rule may be effective for up to ninety (90) days. The Department shall proceed with routine technical rulemaking to permanently adopt these rule changes.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: November 16, 2018
OMS CONTACT PERSON: Dean Bugaj, Comprehensive Health Planner, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4045. Fax: (207) 287-1864. TTY users call Maine relay 711. Email: Dean.Bugaj@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 17, Allowances for Community Support Services
ADOPTED RULE NUMBER: 2018-249 (Emergency)
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts this emergency rule to increase the rates of reimbursement for Community Support Services pursuant to PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (the “Act”), Part D.
The Act requires the Department to amend its rules for reimbursement rates for Community Support Services provided under the provisions of 10-144 CMR Ch. 101, MaineCare Benefits Manual, Ch. III Section 17, “Allowances for Community Support Services”.
Specific changes are as follows:

  • Part D of P.L. 2017, ch. 460 directs the Department to increase the rate of reimbursement for all services by two percent. Sec. D-1 and D-2 specifically require the increase in reimbursement to be applied to the wages and benefits of employees who provide direct services and not to administrators or managers.

Through the Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 17 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates will be effective August 1, 2018; this date comports with the federal law requirement. Pending approval of the proposed changes to the Section 17 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed eight calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the Act and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not an effective rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
Pursuant to 5 MRS §8054, this emergency rule may be effective for up to ninety (90) days. The Department shall proceed with routine technical rulemaking to permanently adopt these rule changes.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: November 16, 2018
OMS CONTACT PERSON: Dean Bugaj, Comprehensive Health Planner, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4045. Fax: (207) 287-1864. TTY users call Maine relay 711. Email: Dean.Bugaj@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 26, Day Health Services
ADOPTED RULE NUMBER: 2018-250 (Emergency)
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts this emergency rule pursuant to PL 2017 ch. 460 Part B-2, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government. Part B-2 requires the Department to amend its rules to increase reimbursement rates for adult family services, adult day services, and homemaker services for the fiscal year ending June 30, 2019, by ten percent (10%). Part B-2 also requires that effective July 1, 2019, payment rats attributable to wages and salaries for personal care and related services will be increased annually by an inflation adjustment cost-of-living percentage in accordance with the United States Department of labor, Bureau of Labor Statistics Consumer Price Index, Medical care services (professional services, nursing home and adult day care services) from the prior December. These cost of living increases shall continue annually until the Department has completed a rate study for adult family care services, adult day services or homemaker services and the rates in the rate study have been implemented.
This emergency rule increases the rate for S5100 HC, Day Care Services.
Through the Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for state plan services must “be published before the proposed effective date of the change” (emphasis added). The Department published its notice of reimbursement methodology change for the Section 26 rates on July 31, 2018. Upon the advice of the Office of the Attorney General, the increased rates will be effective August 1, 2018, which effective date comports with the federal law requirement. Pending approval of the proposed changes to the Section 26 state plan amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed (8) calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the Act, versus the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven-month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve-month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve-month appropriation). This is not an effective rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
Pursuant to 5 MRS §8054, this emergency rule may be effective for up to ninety (90) days. The Department shall proceed with routine technical rulemaking to permanently adopt these rule changes.
The Department is seeking, and anticipates receiving, approval from the Centers for Medicare and Medicaid Services (CMS) for these rate changes. Pending CMS approval, the increased rates will be effective August 1, 2018
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: November 19, 2018
OMS CONTACT PERSON: Anne E. Labonte, Comprehensive Health Planner II, Division of Policy, 242 State Street - 11 State House Station, Augusta, Maine 04333-0011. Telephone: (207) 624-4082. Fax: (207) 287-1864. Email: Anne.Labonte@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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 97, Private Non-Medical Institution (PNMI) Services, and Appendices B, C, D, E, and F
ADOPTED RULE NUMBER: 2018-251 (Emergency)
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts these emergency major substantive rules to implement the requirements of two recently enacted laws: (1) PL 2017 ch. 304, An Act to Amend Principles of Reimbursement for Residential Care Facilities (“The First Act”)and (2) PL 2017 ch. 460, An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (“The Second Act”).The First Act defines the process by which eligible Private Non-Medical Institution (PNMI) Services providers may request an Extraordinary Circumstances Allowance (ECA) and allows for certain regulatory compliance costs incurred by PNMI providers to be considered reasonable and necessary; these changes are implemented in Appendices C and F. The Second Act increases reimbursement for Appendices B, C, and E PNMIs. The Department also adopts various other changes to the Section 97 rules, including Appendix D, as described more specifically below.
The First Act requires ECA, regulatory compliance cost, and other changes in Ch. III Section 97 (the “Main Rule”) and Appendices C, D, and F. The Department finds that these changes must be implemented through emergency major substantive rulemaking. Separately, the Department is implementing changes required by the First Act in 10-144 CMR Ch. 115, Residential Care Facilities – Room and Board Costs (the “State Rule”); those changes are routine technical. Pursuant to 5 MRS §8072, “regular” major substantive rule changes are not legally effective until they are approved by the Legislature and finally adopted by an agency, which can take over a year; as such because the Department seeks to implement the Section 97 changes simultaneously with the state rule changes (in order to treat similar providers equitably), it must do so through emergency major substantive rulemaking. These changes will improve the financial condition of Section 97 providers, and protect against a threat to public health and safety posed by instances of providers closing. The changes are a benefit to PNMI providers, and otherwise have no adverse impact on either MaineCare providers or members.
The emergency adoption under 5 MRS §8074 will enable the rule changes required by the First Act to take effect immediately, and pursuant to 22 MRS §42(8), retroactively. The Change in Reimbursement Methodology Notice required by 42 CFR §447.205 relating to the ECA and regulatory compliance costs was published on October 19. 2017. The Department is seeking, and anticipating receiving, approval from the federal Centers for Medicare and Medicaid Services (CMS) for these changes. Pending approval, the ECA and regulatory compliance cost changes in the main rule, and Appendices C and F, will be effective retroactive to November 1, 2017.
The Second Act, Section B-4, requires the Department to amend the main rule and Appendix C to provide a special supplemental allowance (as more specifically set forth in the rules) for the fiscal year ending June 30, 2019. This allowance must be provided for increases in wages and wage-related benefits for direct care and personal care services cost components. The Second Act also directs that, for fiscal year ending June 30, 2020 and thereafter, the Appendix C MaineCare payment rates attributable to wages and salaries in each cost component must be increased by an inflation factor in accordance with the United States Department of Labor, Bureau of Labor Statistics Consumer Price Index – medical care services index. In addition, the Department added a provision to Appendix C, Sec. 2400.3 to make it clear that the increases in reimbursement required by the Section Act shall not be included in the PNMI facility’s personal care services cost cap.
The Second Act, Part D, requires the Department to amend the main rule, and Appendices B and E, to increase reimbursement rates to ensure a net increase in funding of two percent (as specifically set forth in the rules), which reimbursement must be applied to wages and benefits for employees who provide direct services and not to administrators or managers. The Second Act further requires that Section 97 providers must demonstrate to the Department that the increase in wages and benefits has been granted to direct care workers; as stated in the rules, providers must retain documents reflecting compliance with this requirement in their financial records and provide such documentation to the Department upon request.
Through the Second Act, the Legislature determined that “these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety.” As such, the Act requires the Department to implement “immediate rate increases,” effective July 1, 2018. However, the Act did not become law until July 9, 2018, following a Legislative override of the Governor’s veto.
Because the Second Act involves MaineCare reimbursement, these rule changes are also governed by federal Medicaid law. 42 CFR §447.205(d) requires that public notice of changes in reimbursement for State Plan services must “be published before the proposed effective date of the change.” The Department published its notice of reimbursement methodology change for the Section 97 rates on July 31, 2018. Upon advice of the Office of the Attorney General, the increased rates for Appendices B, C, and E will be effective August 1, 2018, this effective date comports with the federal law requirement. Pending approval of the proposed changes to the Section 97 State Plan Amendment that were submitted to the Centers for Medicare and Medicaid Services, the increased rates in Appendices B, C, and E will be implemented with an August 1, 2018 effective date.
Pursuant to the Legislative determination regarding the urgent need for these reimbursement increases, the requirements of 5 MRS §8054(1) are satisfied and emergency rulemaking is appropriate. Similarly, an August 1, 2018 retroactive effective date is necessary to implement these changes as soon as possible. The retroactive application comports with 22 MRS §42(8), which authorizes the Department to adopt rules with a retroactive application (where there is no adverse impact on providers or members) for a period not to exceed (8) calendar quarters.
To remedy the difference between the July 1, 2018 effective date set forth in the PL 2017, and the August 1, 2018 date that is permissible pursuant to federal Medicaid law, the Department has recalculated the annual appropriation of funds for this service into a temporary eleven month rate. As such, providers will, over the course of eleven months, receive equivalent aggregate payments as would have been received under a twelve month rate. Beginning on July 1, 2019, rates will be annualized (based upon a twelve month appropriation). This is not a rate decrease, but rather a redistribution of the annual appropriation over twelve months, rather than eleven months.
The Department also adopts various other changes to the Section 97 rules, including Appendix D, as described more specifically below.

  • For Appendix D PNMIs, the Department will calculate each Appendix C PNMIs’ rate setting case mix index using the number of MaineCare residents in each case mix classification group in the facility as of March 1st for the July rate and September 1st for the January rate.
  • For Appendix C PNMIs, the Department will send a roster of residents and source of payment as of March 1st and September 1st to facilities for verification prior to rate setting.
  • Removes the Hold Harmless Provision as it is no longer applicable.
  • Procedure codes: S9484 HA, S9484 HE, and S9484 HI, Temporary High Intensity Services, per report per hour, are added to Appendices D, E, and F.
  • Removes procedure code S9484, Temporary High Intensity Services, per report per diem, from Appendix D.
  • Interpreter services is removed from allowability of cost and direct care staff to align with recent Chapter 1 changes.
  • Appendix D updates “mental retardation” to “intellectual disabilities” and “pervasive developmental disorder” to “autism spectrum disorder”.
  • Appendix D procedure codes 6000.4, 6000.6, and 6000.7 are deleted to align current Appendix D fee for service reimbursement. Procedure code 6000.5 is clearly stated in Chapter II, Section 97, Private Non-Medical Institution Services, and as such is deleted.
  • Appendix F 3040 Interim Per Diem Rates updates the Office of Rate-Setting as the entity that sets the facility’s interim daily rate from the Office of MaineCare Services.

Pursuant to 5 MRS §8073, these emergency major substantive rules will remain in effect for up to one year, or until the Legislature reviews the provisionally adopted rule, followed by the Department’s final adoption of the major substantive rule changes.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: November 20, 2018
AGENCY CONTACT PERSON: Heidi Bechard, Comprehensive 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 users call Maine relay 711. Email: Heidi.Bechard@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING 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. 115, Principles of Reimbursement for Residential Care Facilities – Room and Board
ADOPTED RULE NUMBER: 2018-252 (Emergency)
CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts these emergency rule changes in 10-144 CMR Ch. 115, Principles of Reimbursement for Residential Care Facilities – Room and Board Cost to comply with (1) PL 2017 ch. 304 (“The First Act”) and (2) PL 2017 ch. 460, An Act To Amend Principles of Reimbursement for Residential Care Facilities and An Act Making Certain Appropriations and Allocations and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government (“The Second Act”).
The First and Second Acts require ECA, regulatory compliance costs, inflation factor, and special wage allowance changes for Residential Care Facilities and MaineCare Section 97, “Private Non-Medical Institution (PNMI) Services” - Appendix C providers. The Department finds that these changes must be implemented immediately through emergency rulemaking. Separately, the Department is implementing changes required in the First and Second Acts in 10-144 CMR Ch. 101, MaineCare Benefits Manual, Ch. III Section 97, and those changes are major substantive. Pursuant to 5 MRS §8072 “regular” major substantive rule changes are not legally effective until they are approved by the Legislature and finally adopted by an agency, which can take over a year. As such, because the Department seeks to implement the Section 97 changes simultaneously with this State Rule changes (in order to treat providers equitably), it must do so through emergency rulemaking. These changes will improve the financial condition of Residential Care Facility providers, and protect against a threat to public health and safety posed by instances of providers closing. The changes are a benefit to PNMI Appendix C providers and otherwise have no adverse impact on either MaineCare providers or members.
The emergency adoption under 5 MRS §8054 will enable the rule changes to take effect immediately, and pursuant to 22 MRS §42(8), retroactively.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.
EFFECTIVE DATE: November 20, 2018
OMS CONTACT PERSON: Heidi Bechard, Comprehensive 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 users call Maine relay 711. Email: Heidi.Bechard@Maine.gov .
OMS WEBSITE: http://www.maine.gov/dhhs/oms/
DHHS RULEMAKING LIAISON: Kevin.Wells@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 10, Clams and Quahogs: 10.05, Taking of Quahogs in the Sub-tidal Waters of the New Meadows, Brunswick and West Bath
ADOPTED RULE NUMBER: 2018-253
CONCISE SUMMARY: The adopted regulation expands certain existing limitations on the subtidal harvest of quahogs in the New Meadows River. Under the existing regulation, the line north of which the harvest restrictions apply is the Bath/State Road in Brunswick and West Bath. The adopted regulation draws a new line north of which the limitations apply, from the northwestern tip of Indian Point, southeasterly to northern tip of Bragdon Island, continuing east to Bragdon Rock, and then continuing in a northeasterly direction to the point of land at the end of Close Reach Road, West Bath, 43051’21”/069052’1”. By specifying this new line, the existing restriction on the method of harvest to hand digging only, the prohibition on harvesting during the winter months (January-March), and the prohibition on harvesting on Sundays, would extend over the known subtidal quahog resource, in order to better manage the quahog fishery in this area. The rule sunsets the expanded limitations on December 31, 2020. The Department will conduct surveys to determine whether the rule should be continued beyond that date.
EFFECTIVE DATE: November 24, 2018
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Amanda.Ellis@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 25, Lobster and Crab: 25.04, Lobster Trawl Limits
ADOPTED RULE NUMBER: 2018-254
CONCISE SUMMARY: Initiated by the Zone A Council in accordance with 12 MRS §6447, this rule eliminates the Hancock County Trawl Limit area in Zone A. This eliminates the three traps on a trawl maximum in Zone A and allows license holders to fish longer trawls (more traps on a trawl). The proposal was supported by over two-thirds of the Zone A license holders voting in a referendum conducted in June 2018. On August 29, 2018, the Zone A Council voted unanimously to recommend to the Commissioner to advance this proposal to rule-making.
EFFECTIVE DATE: November 24, 2018
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Amanda.Ellis@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 36, Herring Regulations: 36.01, Herring Management Plan
ADOPTED RULE NUMBER: 2018-255 (Emergency)
CONCISE SUMMARY: Atlantic herring may only be landed from Management Area 1A on days that have been designated landing days by the Atlantic States Marine Fisheries Commission (ASMFC). The Atlantic Herring Section held a Days Out conference call on November 13, 2018 to amend the landing days for Trimester 3 (October 1 – December 31) and designated seven landings days for all vessels. All vessels landing herring caught in Management Area 1A in any Maine port are limited to one landing per 24 hour period (6:00 p.m. to 6:00 p.m.). The Commissioner has determined that it is necessary to take emergency action to implement these limitations to comply with the changes to the interstate management of the Atlantic herring resource. The Commissioner hereby adopts this emergency regulation as authorized by 12 MRS §6171(3)(C).
EFFECTIVE DATE: November 16, 2018
AGENCY CONTACT PERSON: Melissa Smith, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6558. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Melissa.Smith@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 37, Freshwater Fish Regulations
ADOPTED RULE NUMBER: 2018-256
CONCISE SUMMARY: This rule makes it unlawful to take or possess brown trout which are greater than 25 inches in total length, from the coastal waters of the State of Maine. The rule mirrors the 25” maximum for brown trout as established by the Maine Department of Inland Fisheries and Wildlife. The intent of the rule is to provide brown trout fishermen with a consistent maximum size across waterbodies.
EFFECTIVE DATE: November 24, 2018
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Amanda.Ellis@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 91 (New), Spat Collection
ADOPTED RULE NUMBER: 2018-257
CONCISE SUMMARY: The Department of Marine Resources has adopted a new chapter of regulation for the collection of scallop spat under the spat collection license (12 MRS 6074-A). The rules create a maximum size for the possession and sale of scallop spat of 2 inches. It limits a license holder to no more than 15 vertical lines, with a maximum of 30 spat collection bags per line. The rule limits the size of bags that may be used, and specifies marking requirements. It requires that all collection equipment is removed from the coastal waters during the month of July, and specifies the records a license holder must retain.
EFFECTIVE DATE: November 24, 2018
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Amanda.Ellis@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .

AGENCY: 13-188 – Department of Marine Resources (DMR)
CHAPTER NUMBER AND TITLE: Ch. 110, Marine Harvesting Demonstration License
ADOPTED RULE NUMBER: 2018-258
CONCISE SUMMARY: Pursuant to 12 MRS §6810-A(7-A), Marine Harvesting Demonstration License holders are exempt from prohibitions on raising and hauling lobster traps during closed periods as specified in 12 MRS §6440 subsection 2. This rule removes language from the existing regulation, which did not recognize the exemption provided for in statute. This is a minor technical change intended to provide consistency between relevant statutory provisions and the regulation.
EFFECTIVE DATE: November 24, 2018
AGENCY CONTACT PERSON: Amanda Ellis, Department of Marine Resources, 21 State House Station, Augusta, Maine 04333. Telephone: (207) 624-6573. Fax: (207) 624-6024. TTY: (207) 633-9500 (Deaf/Hard of Hearing). Email: Amanda.Ellis@Maine.gov .
DMR RULEMAKING WEBSITE: http://www.maine.gov/dmr/rulemaking/ .
DMR RULEMAKING EMAIL: dmr.rulemaking@maine.gov .
DMR WEBSITE: http://www.maine.gov/dmr/ .
DMR RULEMAKING LIAISON: Deirdre.Gilbert@Maine.gov .