- All participants in this program must be determined to be financially eligible
for MaineCare, Medicaid benefits. The Bureau of Family Independence (BFI) does
this.
- There must be a current Individual Support Plan, less than one year old at
time of classification, consumer or guardian if appropriate must sign plan. Plan
must detail why there is a need for waiver services and that there is an apparent
need for ICF-MR level of care and services.
- A signed Choice Letter dated after the date of the above plan, but before the
first date of waiver services.
- A completed BMS-99 form signed by attending physician. Signature must be less
than sixty day’s old as of the date of received in the Central Office Waiver
Services Division.
- A completed and signed waiver checklist that details the authorization of particular
waiver services.
- If the consumer is found to be both financial and medically and there is an
opening available for them they will be so notified by the Central Office staff.
|
- Participant must continue on-going Medicaid eligibility.
- Updated support plan less than one year old as of date for reclassification.
There needs to be detail as to why this need is on going or remains in effect.
- An updated BMS –99 form that does not require a physician
signature.
- A signed waiver checklist that details current authorizations.
- The above information is due in Central Office by the date of classification.
- Reclassification applications received after thirty working days of the review
date shall be authorized for services as of the date the reclassification application
is received.
- When the reclassification packet has not be received and processed after thirty-calendar
days beyond the due date payment to the provider will stop, until such time that
the classification is completed.
|
- Participant must be determined financially eligible for MaineCare benefits
for this level of care.
- A recent plan of care less than six months old needs to recommend such placement.
This most commonly is the pre-placement meeting that takes place less than 30
day’s prior to placement.
- A psychological evaluation that is less than one year old. This should
document that the individual is likely to benefit from the placement into such
a facility.
- A completed BMS-85 form and physical signed by a physician that is completed
no sooner than seven day’s prior to admission and no later than forty-eight
hours following admission.
- It is the responsibility of the receiving facility to make sure that number
four above is completed, however case-management staff will often assist with
this responsibility.
|
