Notice of Agency Rule-making Proposal

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Notice of Agency Rule-making Proposal

 

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 notice of two Agency Rule-making Proposals. You can access the complete rules at http://www.maine.gov/dhhs/oms/rules/index.shtml

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Notice of Agency Rule-making Proposal

 

AGENCY: Department of Health and Human Services, MaineCare Services

 

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

 

PROPOSED RULE NUMBER:

 

CONCISE SUMMARY: This proposed rule complies with 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 amends its rules for reimbursement rates for the home-based and community-based personal care services under the provisions of 10-144 C.M.R. ch. 101, MaineCare Benefits Manual, Chapter III, Section 12, Allowances for Consumer-Directed Attendant 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. 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.

 

The Department is seeking and anticipates receiving approval from the federal Centers for Medicare and Medicaid Services (CMS) for these changes. Pending CMS approval, the increased reimbursement rates 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. A methodology change notice was posted on the Office of MaineCare Services’ website on September 5, 2017.

 

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

 

STATUTORY AUTHORITY: 22 M.R.S. §§ 42(8), 3173, 5 M.R.S. §8054, Public Law 2017, Chapter 284, Parts MMMMMMM-1 and TTTT-1

 

PUBLIC HEARING:

 

Date:               December 12, 2017

Time:              11:00 a.m.

Location:         Burton Cross Office Building

                        Conference Room 400

                        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 5, 2017.

 

DEADLINE FOR COMMENTS:        Comments must be received by 11:59 p.m. on December 22, 2017.

 

AGENCY CONTACT PERSON:        Heidi Bechard, Comprehensive Health Planner II

Heidi.Bechard@maine.gov

AGENCY NAME:                                 MaineCare Services

ADDRESS:                                             242 State St.

11 State House Station

                                                                 Augusta, Maine  04333-0011

                                                                 Heidi.bechard@maine.gov

TELEPHONE:                                       207-624-4074 FAX: (207) 287-1864

                                                                 TTY: 711 (Deaf or Hard of Hearing)

 

IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department does not anticipate that this rulemaking will have any impact on municipalities or counties.

____________________________________________________________________________

 

Notice of Agency Rule-making Proposal

 

AGENCY: Department of Health and Human Services, MaineCare Services

 

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

 

PROPOSED RULE NUMBER:

 

CONCISE SUMMARY: These proposed rules seek to increase rates of reimbursement and level of care limits for personal care and 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 for the home-based and community-based personal care services under the provisions of 10-144 C.M.R. ch. 101, MaineCare Benefits Manual, Chapters II & III, 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 the rates. See Part ZZZZZZ, Section ZZZZZZ-2. In addition, Part MMMMMMM-1 directs the Department to ensure that caps and limitations on home-based and community-based personal care and related services are increased to reflect the increase in reimbursement rates that result from this section.

 

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 propose rule seeks to increase 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 proposed rule seeks to increase the following level of care limits:

 

Level I

Level II

Level III

Level IV

Level

Level VIII

Level IX

 

The Department is seeking and anticipates receiving approval from the federal Centers for Medicare and Medicaid Services (CMS) for these changes. Pending approval, the increased reimbursement rates and corresponding increases in level of care limits will be effective retroactive to July 1, 2017 through June 30, 2018. The new rates and level of care limits will sunset on June 30, 2018, as the rate increases were funded by single year appropriations. Rates and level of care limits will revert to original values on July 1, 2018. A methodology change notice was posted on the Office of MaineCare Services’ website on September 5, 2017.

 

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

 

STATUTORY AUTHORITY: 22 M.R.S. §§ 42, 3173; Public Law 2017, ch. 284, Part MMMMMMM-1

 

PUBLIC HEARING:

 

Date:                December 11, 2017

Time:               10:00 a.m.

Location:         Burton Cross Building

                          Room 400, 11 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 4, 2018.

 

DEADLINE FOR COMMENTS:        Comments must be received by 11:59 p.m. on December 21, 2017.

 

AGENCY CONTACT PERSON:        Heidi Bechard, Comprehensive Health Planner II

Heidi.Bechard@maine.gov

AGENCY NAME:                                 MaineCare Services

ADDRESS:                                             242 State St.

11 State House Station

                                                                 Augusta, Maine  04333-0011

TELEPHONE:                                       (207) 624-4074 FAX: (207) 287-1864

                                                                 TTY: 711 (Deaf or Hard of Hearing)

 

IMPACT ON MUNICIPALITIES OR COUNTIES (if any): The Department anticipates these rulemakings will not have any impact on municipalities or counties.

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