Concise Summary: This proposed rule will permanently adopt language in Chapter 115, Principles of Reimbursement for Residential Care Facilities- Room and Board Costs that currently only allows bedhold hold reimbursement when an associated PNMI treatment cost has also been billed under MaineCare. Providers billing for PNMI room and board costs under Chapter 115 (PNMI Appendices C and F only) will still be able to bill up to thirty (30) bedhold days per calendar year when a member is absent from the facility. The codes used for this billing continue to be reimbursed with the billing codes “BL” and “MRBL.” This will allow for continued reimbursement of some routine fixed costs that are not eliminated when the member is temporarily absent from the facility. These funds are reimbursed by all state dollars, and are not matched with reimbursement from the federal Medicaid program

Deadline for Comments: Comments must be received by midnight September 28, 2008

CONCISE SUMMARY: The Office of Maine Care Services is adopting changes to 10-144 CMR, Chapter 115, Principles of Reimbursement for Residential Care Facilities- Room and Board Costs. The Department has changed Definition 24 (b), 28 (c) and Sections 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)(2) to restore language that was inadvertently changed during the November 1, 2007 rulemaking. This rulemaking has no adverse impact on small business.

Effective Date: July 1, 2008.

CONCISE SUMMARY: The Department has determined that the immediate adoption of these rules is necessary to comply with legislative requirements and federal Medicaid rules. This emergency rule removes language in Chapter 115, Principles of Reimbursement for Residential Care Facilities- Room and Board Costs that currently only allows bedhold hold reimbursement when an associated PNMI treatment cost has also been billed under MaineCare. In a separate rulemaking, the Department has eliminated reimbursement for Private Non-Medical Institution (PNMI) bedhold days for those days reimbursed by the MaineCare program. Providers billing for PNMI services under Appendices C and F will still be able to bill up to thirty (30) bedhold days per calendar year when a member is absent from the facility. The codes used for this billing continue to be reimbursed with the billing codes "BL" and "MRBL." This will allow for continued reimbursement of some routine fixed costs that are not eliminated when the member is temporarily absent from the facility. These funds are reimbursed by all state dollars, and are not matched with reimbursement from the federal Medicaid program. This rulemaking will remain in effect for ninety days while the Department promulgates rules to permanently adopt this initiative.

Effective Date: August 1, 2008 – October 29, 2008 .