Public Input for Proposed Rules
Notices are published each Wednesday to alert the public regarding state agency rule-making. 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 rule-making if the petition is signed by 150 or more registered voters, and may begin rule-making 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 §11112). WorldWide 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 rule-making liaisons (http://www.maine.gov/sos/cec/rules/liaisons.html), 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. II & III Section 17, Community Support Services
PROPOSED RULE NUMBER: 2016-P133
CONCISE SUMMARY:
1. Following various changes to Ch. II Section 17, "Community Support Services", adopted by the Department on March 22, 2016, certain members no longer met clinical criteria for Community Support Services. This prompted a legislative review of the Section 17 rule changes, after which the Legislature enacted Resolves 2016 ch. 82 (eff. Apr. 26, 2016). This Resolve requires the Department to extend the authorized service period for certain individuals who no longer meet clinical criteria for Section 17 services after the rule changes adopted on March 22, 2016. For members affected by the March 22nd rule change, the Department shall authorize a 120 day extension for the member's Section 17 services. Additionally, 90-day extensions may be granted, provided the member is able to reasonably demonstrate to the Department, or Authorized Entity, that he or she has attempted to, and has been unable to, access medically necessary covered services under any other section of the MaineCare Benefits Manual. The Ch. II changes shall be effective retroactive to April 26, 2016. The temporary transition period shall end on June 30, 2017.
2. Separately, the Legislature enacted An Act to Increase Payments to MaineCare Providers that are Subject to Maine's Service Provider Tax, PL 2016, ch. 477 (eff. Apr. 15, 2016). Certain MaineCare providers subject to the service provider tax have experienced an increase in the tax to 6% since January 1, 2016. The Legislature thus provided additional appropriations to certain MaineCare providers, including Section 17 providers, in an effort to offset the increase in the provider tax. The Department is seeking and anticipates CMS approval of the reimbursement changes for Section 17 providers. Pending approval, the Department will reimburse providers under the new increased rates retroactively to July 1, 2016 pursuant to PL 2016 ch. 477 (eff. Apr. 15, 2016).
3. Each of the new laws were enacted by the Legislature on an emergency basis. Given that each law provides benefits to the regulated community, and the time-sensitive, limited nature of the extension in eligibility, the Department was authorized to enact these changes to Section 17 on an emergency basis, without the findings required by 5 MRS §8054(2). These emergency rule changes were filed and were effective for ninety (90) days. The Department is now engaging in proposed routine technical rule-making to permanently adopt these Section 17 rule changes.
4. Finally, the Department notes that on April 29, 2016, the Legislature overrode the Governor's veto of LD 1696, Resolve, To Establish a Moratorium on Rate Changes Related to Rule Chapter 101: MaineCare Benefits Manual, Sections 13, 17, 28 and 65 (Resolves 2016 ch. 88). That law imposes a moratorium on rule-making to change reimbursement rates, including Section 17, until after a rate study has been completed and presented to the Legislature. The Department consulted with the Office of Attorney General and the Office of the Attorney General determined and has advised the Department that Resolves 2016 ch. 88 does not prevent the rule changes because (1) the separate law, PL 2016 ch. 477, is more specific in regard to changing reimbursement for providers impacted by the Service Provider Tax increase; and (2) these are reimbursement rate increases, thus providing a benefit to MaineCare providers.
5. This rule-making proposes to remove Clubhouse services and Specialized Group services as they are now available and covered through Section 65, "Behavioral Health Services". This will remove the duplication of service and all references to the service within this rule.
6. This rule proposes adding a definition for the Adult Needs and Strengths Assessment, as well as provider requirements for filling out and reporting the assessment at regular intervals via the Department's Enterprise Information System.
7. This proposed rule aims to add language giving members the option to request to hold for service if providers are unable to meet the seven (7) day face-to-face requirement of new referrals. Members may elect to hold for service only after an agency has adequately informed the member of their options.
8. The rule also seeks to add language to the Individualized Service Plan in 17.04-1.E requiring a goal on a member's access to primary care, specialty care, and routine appointments. This also requires the MHRT to document evidence of the visit as described in 17.04-1.N.
9. Lastly, this rule seeks to update language of CMS approval about the inclusion of Certified Peer Support Specialists (CIPSS) as part of the ACT Team defined in 17.04-3.A-5.
See http://www.maine.gov/dhhs/oms/rules/index.shtml for rules and related rule-making documents.
PUBLIC HEARING: Thursday, October 06, 2016 - 9 a.m. - 12 p.m., 19 Union Street - Room 110, Augusta, Maine. The Department requests that any interested party requiring special arrangements to attend the hearing contact the agency person listed below before September 30, 2016.
DEADLINE FOR COMMENTS: Comments must be received by 11:59 p.m. on Saturday, October 22, 2016
AGENCY CONTACT PERSON / SMALL BUSINESS 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). E-mail: Dean.Bugaj@Maine.gov .
IMPACT ON MUNICIPALITIES OR COUNTIES: The Department anticipates that this rule-making will not have any impact on municipalities or counties.
ADOPTIONS
Pursuant to Ch. 380 of the Public Laws of 2011, notice of the adoption of rules will no longer be published in the newspaper rule-making notices; our Wednesday web notices will continue to carry them, however. Information on rules adopted through the Maine Administrative Procedure Act as well as the full text of adopted rules is available on the internet at http://www.maine.gov/sos/cec/rules .
↧