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Home > Provider > Policies/Rules > Other Rules

Department of Health and Human Services
Office of MaineCare Services

Other Rules

The Office of MaineCare Services, formerly the Bureau of Medical Services, Division of Policy and Provider Services performs rulemaking to implement and update policies for the programs listed below. Adopted rules for these programs are available on the Secretary of State (SOS) website.  

  • Maine State Services Manual - MaineRX and DEL (10-144, Department of Health and Human Services, Chapter 104)
  • Medical Eye Care (10-144, Department of Health and Human Services, Chapter 107)
  • Quality Oversight for Commercial Health Maintenance Organizations (10-144, Department of Health and Human Services, Chapter 109)
  • Free Care Guidelines (10-144, Department of Health and Human Services, Chapter 150)
  • Maine Certificate of Need Procedures Manual for Health Care Facilities - Other Than Nursing Care Facilities (10-144, Department of Health and Human Services, Chapter 503)

Proposed, recently adopted and emergency rules for the programs are posted below. Any policy clarifications regarding adopted policies are also posted below.

Note: Although adopted rules are posted on the SOS website, there is always a delay between the effective date the Office of MaineCare Services adopts a rule and the date it is posted on the SOS website. Therefore, the Office of MaineCare Services posts recently adopted rules here until they are posted on the SOS website.

Proposed

Rule

Download

Chapter 115, Principles of Reimbursement for Residential Care Facilities- Room and Board Costs

(.doc) (.pdf)

CONCISE SUMMARY: The Office of Maine Care Services is proposing changes to 10-144 CMR, Chapter 115, Principles of Reimbursement for Residential Care Facilities- Room and Board Costs. The Department is proposing changes to Definition 24 (b), 28 (c) and Principle’s 20.43 (b) and 30.62 where language was added to clarify when investment income from gifts, grants and endowments would be applied. Finally, the Department also made grammatical changes in Sections 20.32 (b)(1) and 20.32 (b)(3) to restore language that was inadvertently changed during the November 1, 2007 rulemaking.


Deadline for Comments: Comments must be received by midnight May 2, 2008.

Submit Comments on Proposed Rules

Recently Adopted

Rule

Download

10-144, Chapter 275, Section 2, Reporting of Prescription Drug Marketing Costs

(.doc) (.pdf)

CONCISE SUMMARY: The rule requires manufacturers and labelers of prescription drugs to report gifts and marketing costs to the Department in order to assist the State in its role as a purchaser of prescription drugs and an administrator of prescription drug programs. This will enable the State to determine the scope of prescription drug marketing costs and their effect on the cost, utilization, and delivery of health care services and furthering the role of this State as guardian of the public interest.

EFFECTIVE DATE: October 6, 2006

Read Responses to comments (.pdf)
Guidance Letter for Drug Manufacturers (.pdf)
Sample Spreadsheet (xls.)

10-144, Chapter 275, Section 1, and Office of Attorney General, 26-239, Chapter 111-Prescription Drug Clinical Trial Reporting

(.doc) (.pdf)

CONCISE SUMMARY: The rule defines the obligations of manufacturers and labelers of prescription drugs and biological products to publicly disclose on Internet websites information about clinical trials of drugs or biological products that are or have been FDA-approved for marketing and are or have been dispensed, administered, delivered or promoted in Maine. The final rule further clarifies the required content, timing and location of these disclosures, and indicates for which clinical trials this information is required.

EFFECTIVE DATE: March 1, 2007

Read Responses to comments (.doc) (.pdf)

Chapter 104, Section 4: Naine Part D Wrap Benefits

(.doc) (.pdf)

CONCISE SUMMARY: Pursuant to the federal guidelines that determine the Part D Benefit parameters, the member co-payment for generic drugs has increased from $2.15 to $2.25 per prescription. The Part D Wrap Benefit covers this co-payment for eligible beneficiaries. The new co-pay amount is reflected in the Appendix to this rule. Additionally, Section 4.03 has been updated in order to clarify the eligibility and enrollment requirements for Part D Wrap Benefits.

EFFECTIVE DATE: February 9, 2008

Read Responses to comments (.doc) (.pdf)

Chapter 275, Section 3, Fee Provision to Implement Prescription Privacy Law

(.doc) (.pdf)

CONCISE SUMMARY: The purpose of this rule is to implement the fee, payable to the State by manufacturers of prescription drugs, pursuant to 22 M.R.S.A. §1711-E, subsection 4(C). The fee is to implement the program established by statute so that prescribers may protect the confidentiality of prescription drug information identifying the prescriber from use for marketing, thereby serving the State’s interests in improving public health, limiting annual increases in the cost of health care and protecting the privacy of patients and prescribers in the health care system of this State.

 

The Department shall assess an annual fee of $1,500 payable by October 1st each year, beginning in 2007, on manufacturers of prescription drugs whose drugs are dispensed to members of the MaineCare program and enrollees in the elderly low-cost drug program. This rule is applicable only to manufacturers or labelers of prescription drugs dispensed in this State that employ, direct or utilize marketing representatives in this State. The fee that by statute is due for 2007 shall be due 30 days after adoption of this rule.

EFFECTIVE DATE: March 22, 2008

Read Responses to comments (.doc) (.pdf)

Emergency

There are no Emergency Rules at this time.