Emergency Rule-Making Adoptions: Chapter III, Section 12, Allowances for Consumer-Directed Attendant Services and Chapters II & III, Section 96, Private Duty Nursing and Personal Care Services

Maine Department of Health & Human Services sent this bulletin at 11/14/2017 04:07 PM EST

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The Division of Policy posts all proposed and recently adopted rules on MaineCare’s Policy and Rules webpage. This website keeps the proposed rules on file until they are finalized and until the Secretary of State website is updated to reflect the changes. The MaineCare Benefits Manual is available on-line at the Secretary of State’s website.

Below, please find two notices of Agency Emergency Rule-making Adoption. You can access the complete rules at http://www.maine.gov/dhhs/oms/rules/index.shtml

Notice of Agency Emergency Rule-making Adoption

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. ch. 101, MaineCare Benefits Manual (MBM), Chapter III, Section 12, Allowances for Consumer-Directed Attendant Services

ADOPTED RULE NUMBER:

CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts this emergency rule to increase the rates of reimbursement for personal care services provided through Chapter III, Section 12, Allowances for Consumer-Directed Attendant Services pursuant to Public Law 2017, ch. 284, Part MMMMMMM-1, An Act Making Unified Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2018 and June 30, 2019. The Department is seeking and anticipates receiving approval from the federal Centers for Medicare and Medicaid Services (CMS) for this change. Pending approval, the increased rates of reimbursement will be effective retroactive to July 1, 2017 through June 30, 2018. The new rates will sunset on June 30, 2018, as the rate increases were funded by single year appropriations. Rates will revert to original values on July 1, 2018.

The adopted rule ensures vulnerable members have access to medically necessary covered services and providers of Attendant Care Services will receive increased rates of reimbursement. Otherwise, the Department anticipates no adverse impact on either MaineCare providers or members. Further, this change is not expected to have an adverse effect on the administrative burdens of small businesses.

http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rulemaking documents.

EFFECTIVE DATE: November 14, 2017

AGENCY CONTACT PERSON: Heidi Bechard, Comprehensive Health Planner

Heidi.Bechard@maine.gov

AGENCY NAME: Division of Policy

ADDRESS: 242 State Street

11 State House Station

Augusta, Maine 04333-0011

TELEPHONE: (207) 624-6951 FAX: (207) 287-1864

TTY users call Maine relay 711

Notice of Agency Rule-making Emergency Adoption

AGENCY: Department of Health and Human Services, MaineCare Services

CHAPTER NUMBER AND TITLE: 10-144 C.M.R. ch. 101, Chapters II & III, Section 96, Private Duty Nursing and Personal Care Services

ADOPTED RULE NUMBER:

CONCISE SUMMARY: The Department of Health and Human Services (“the Department”) adopts these emergency rules to increase the rates of reimbursement and level of care limits for personal care and other related services pursuant to Public Law 2017, ch. 284, Part MMMMMMM-1, An Act Making Unified Appropriations and Allocations for the Expenditures of State Government, General Fund and Other Funds and Changing Certain Provisions of the Law Necessary to the Proper Operations of State Government for the Fiscal Years Ending June 30, 2018 and June 30, 2019.

P.L. 2017, ch. 284, Part MMMMMMM-1 requires the Department to amend its rules for reimbursement rates and level of care limits for home-based and community-based personal care and related services provided under the provisions of 10-144 C.M.R Ch. 101, MaineCare Benefits Manual, Chapters II & III, Section 96, Private Duty Nursing and Personal Care Services and referenced 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. Further, Part MMMMMMM-1 directs the Department that the increase in rates of reimbursement must be applied in equal proportion to all home-based and community-based personal care and related services referenced in the Burns & Associates, Inc. report using the funding provided for that purpose in Chapter 284. Chapter 284 provides funding to increase these rates. See Part ZZZZZZ, Section ZZZZZZ-2.

P.L. 2017, ch. 284, Part TTTT, Section TTTT-1 authorizes the Department to adopt rules increasing these rates and level of care limits on an emergency basis without the necessity of demonstrating that immediate adoption is necessary to avoid a threat to public health, safety or general welfare.

The Legislature did not appropriate additional funding for these rate and level of care increases beyond June 30, 2018, therefore, rates and level of care increases will revert to their current levels (pre-July 1, 2017) on July 1, 2018.

This Chapter III emergency rule increases the following rates:

G0299 (0551)-RN Services

G0299 TD UN (0551)-RN Services–multiple patients (2)

G0299 TD UP (0551)-RN Services-multiple patients (3)

G0300 TE (0559)-LPN Services

G0300 TE UN (0559)-LPN Services–multiple patients (2)

G0300 TE UP (0559)-LPN Services–multiple patients (3)

T1000 TD-Independent RN

T1000 TD UN-Independent RN-multiple patients (2)

T1000 TD UP-Independent RN–multiple patients (3)

T1004 (0571)-Home Health Aide/Certified Nursing Assistant Services

T1004 UN (0571)-Home Health Aide/Certified Nursing Assistant Services-multiple patients (2)

T1004 UP (0571)-Home Health Aide/Certified Nursing Assistant Services–multiple patients (3)

T1019 (0589)-Personal Support Services

T1019-Personal Support Services (PCA Agencies only)

T1019 UN-Personal Support Services (PCA Agencies only) multiple patients (2)

T1019 UP-Personal Support Services (PCA Agencies only) multiple patients (3)

S5125 TF (0589)-PCA Supervisit

S5125 TF UN (0589)-PCA Supervisit-multiple patients (2)

S5125 TF UP (0589)-PCA Supervisit–multiple patients (3)

S5125 TF-PCA Supervisit (PCA Agencies only)

S5125 TF UN-PCA Supervist (PCA Agencies only) multiple patients (2)

S5125 TF UP-PCA Supervisit (PCA Agencies only) multiple patients (3)

This Chapter II emergency rule increases the following level of care limits:

Level I

Level II

Level III

Level IV

Level V

Level VIII

Level IX

Pursuant to 5 M.R.S. § 8054, these emergency rules may be effective for up to ninety (90) days. The Department intends to proceed with routine technical rulemaking to permanently adopt these rules.

These changes are not expected to have an adverse effect on the administrative burdens of small businesses.