Notice of Agency Waiver Amendment

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 Rule-making Proposal. You can access the complete rule 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, Office of MaineCare Services

 

CHAPTER NUMBER AND TITLE: 10-144 C.M.R., Chapter 104, Maine State Services, Manual Section 7, Abortion Services for MaineCare Members

 

PROPOSED RULE NUMBER:

 

CONCISE SUMMARY:

 

This proposed rulemaking will implement P.L. 2019, c. 274, An Act to Prevent Discrimination in Public and Private Insurance Coverage for Pregnant Women in Maine (the “Act”), which requires state-funded coverage for abortion services to MaineCare members when those services are not covered by Medicaid.

 

Federal law limits Medicaid reimbursement to those abortions necessary to protect the life of the mother, or when the pregnancy results from rape or incest (the “Hyde Exceptions.”). See, e.g., 42 C.F.R. §§ 441.200-441.208; 10-144 C.M.R. Ch. 101 (the “MaineCare Benefits Manual”), Ch. II, Sec. 90.05-2 (MaineCare rule implementing Hyde Exceptions). The Act requires that, for MaineCare eligible women, abortion services that are outside the Hyde Exceptions (i.e., not covered Medicaid services) must be funded separately by using state funds within existing resources. The Legislature appropriated from the General Fund approximately $227,546 and $375,843, respectively, for the next two fiscal years to provide these new state-funded abortion services. See the Act, Sec. 10 (Appropriations and allocations). The Department requires providers to identify state-funded abortion services when submitting claims for reimbursement of state-funded abortion services. This allows the Department to distinguish the state-funded abortion claims from those that are covered under the Hyde Exceptions, in order to maintain compliance with federal Medicaid restrictions and requirements for reimbursement.

 

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 HEARING: 

 

Date and Time:  Monday, October 21, 2019 at 9:00 a.m.        

Location:           State Office Bldg., Maine A Conf. Rm., 109 Capitol St., Augusta, ME

 

The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before October 14, 2019.

 

DEADLINE FOR COMMENTS:   Comments must be received by 11:59 p.m. on October 31, 2019.