Emergency Rule Adoption: Chapter II, Section 28, Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations

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

 

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Notice of Agency Emergency Rule-making Adoption

 

AGENCY:  Department of Health and Human Services, Office of MaineCare Services

 

CHAPTER NUMBER AND TITLE:   10-144 C.M.R., Chapter 101, Chapter II, Section 28,  Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations         

 

ADOPTED RULE NUMBER:

 

CONCISE SUMMARY:

 

On November 8, 2018, the Department adopted the emergency major substantive rule for Ch. III, Sec. 28 (Allowances for Rehabilitative and Community Support Services for Children with Cognitive Impairments and Functional Limitations). The emergency major substantive rulemaking was done to comply with Public Law 2017, Ch. 460 (“the Act”) which directed the Department to amend reimbursement rates to Section 28 providers to reflect final rates modeled in the April 2017 Burns report: Rate Study for Behavioral Health and Targeted Case Management Services: Final Proposed Rates for Formal Rulemaking, and also to increase the rate of reimbursement for all services by two percent. The legislation was enacted as an emergency, and directed the Department to make the rate increases effective July 1, 2018. Pursuant to the emergency major substantive rule, in order to comport with federal Medicaid law, the rate increases were made with an August 1, 2018 effective date.

 

The November 8, 2018 emergency major substantive rule also added a new procedure code for Board Certified Behavior Analyst (BCBA) services (Procedure Code G9007), pursuant to the Act, which required the Department to “establish new reimbursement rates” in accordance with the 2017 Burns rate study.

 

The Department proposed rules for Ch. III, Section 28, in accordance with 5 M.R.S. § 8072(1), to be provisionally adopted by the Department, pending legislative approval.  The Department received comments during that rulemaking requesting clarification on the services that would be eligible for the August 1, 2018 BCBA services rate.

 

Therefore, the Department has determined that emergency rulemaking is required in order to clarify the services that are eligible for the new BCBA service rate.  Pursuant to 5 M.R.S. § 8054, the Department finds that immediate adoption of the Ch. II, Section 28 rate is necessary to avoid an immediate threat to public health, safety or general welfare, since the Legislature determined through the Act 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.” P.L. 2017, Ch. 460.

 

This emergency rulemaking provides for a new provision in the rule identifying BCBA services in the Covered Services section of the rule.  In addition, the emergency rule identifies the requirements for BCBA providers, consistent with requirements set forth by the Behavioral Analyst Certification Board. These standards are in effect on the effective date of this emergency rule.

 

BCBA services rendered between August 1, 2018, the effective date of the November 8, 2018, Ch. III, Section 28, emergency major substantive rule, and the effective date of this emergency rule, will be reimbursed in accordance with the emergency major substantive rule BCBA rate, and the Ch. II rule in effect at that time.

 

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

 

EFFECTIVE DATE:                             June 25, 2019

AGENCY CONTACT PERSON:        Dean Bugaj, Comprehensive Health Planner

AGENCY NAME:                               Division of Policy

ADDRESS:                                          109 Capitol Street

             11 State House Station

             Augusta, Maine 04333-0011

EMAIL:                                               Dean.Bugaj@maine.gov

TELEPHONE:                                     (207)-624-4045   FAX: (207) 287-6106

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